LIFERESTORE MD USA NC1 LLC NPI 1417530593

NPI Information

NPI: 1417530593
Provider Name: LIFERESTORE MD USA NC1 LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1427 MILITARY CUTOFF RD STE 140
WILMINGTON, NC
ZIP 28403
Phone: (214) 494-8121
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LIFERESTORE MD USA NC1 LLC is a multi-specialty clinic center in Wilmington, NC. LIFERESTORE MD USA NC1 LLC NPI is 1417530593. The provider is registered as an organization entity type.

The provider's business location address is:

1427 MILITARY CUTOFF RD STE 140
WILMINGTON, NC
ZIP 28403-692
Phone: (214) 494-8121

The provider's authorized official is Bob Olovsson .
The authorized official title is Coo and has the following contact phone number (214) 494-8121.

The enumeration date for this NPI number is 5/5/2021 and was last updated on 5/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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