| Restoring Essential Connections | |
|
2075 Knowles Rd Medford OR 97501-9530 | |
| (541) 944-8246 | |
| Not Available |
| Full Name | Restoring Essential Connections |
|---|---|
| Speciality | Social Worker |
| Location | 2075 Knowles Rd, Medford, Oregon |
| Authorized Official Name and Position | Lynn Wiltrout (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Contact | 5416222727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoring Essential Connections Po Box 1770 Phoenix OR 97535-1770 Ph: (541) 622-2727 | Restoring Essential Connections 2075 Knowles Rd Medford OR 97501-9530 Ph: (541) 944-8246 |
| NPI Number | 1144979063 |
|---|---|
| Provider Enumeration Date | 03/18/2022 |
| Last Update Date | 10/20/2023 |
| Certification Date | 10/20/2023 |
| Medicare PECOS PAC ID | 8325429723 |
|---|---|
| Medicare Enrollment ID | O20220717000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144979063 | NPI | - | NPPES |
| Provider Name | Josh C. Bratton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447672092 PECOS PAC ID: 6002146420 Enrollment ID: I20190927002915 |
| Provider Name | Bronson N. Dull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184085151 PECOS PAC ID: 0941616445 Enrollment ID: I20210308002578 |
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