Provider Demographics
NPI:1336806280
Name:JOINT RESTORATION CENTER LLC
Entity Type:Organization
Organization Name:JOINT RESTORATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUNK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:817-726-0411
Mailing Address - Street 1:8108 SANDHILL CRANE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76118-4506
Mailing Address - Country:US
Mailing Address - Phone:817-726-0411
Mailing Address - Fax:
Practice Address - Street 1:8014 S 101ST EAST AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4580
Practice Address - Country:US
Practice Address - Phone:539-777-2112
Practice Address - Fax:539-777-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-25
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty