Provider Demographics
NPI:1922008465
Name:RESTORATIVE SOLUTIONS LLC
Entity Type:Organization
Organization Name:RESTORATIVE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:APLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-336-9068
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-0286
Mailing Address - Country:US
Mailing Address - Phone:586-336-9068
Mailing Address - Fax:586-336-9257
Practice Address - Street 1:11415 BAYBERRY DR
Practice Address - Street 2:
Practice Address - City:BRUCE
Practice Address - State:MI
Practice Address - Zip Code:48065-3744
Practice Address - Country:US
Practice Address - Phone:586-336-9068
Practice Address - Fax:586-336-9257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRFO 00020332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2376183Medicaid
MI4319544Medicaid
4226440001Medicare ID - Type Unspecified