| Restore Therapy Group | |
|
2583 Turpins Glen Dr Germantown TN 38138-5820 | |
| (901) 318-0506 | |
| Not Available |
| Full Name | Restore Therapy Group |
|---|---|
| Speciality | Social Worker |
| Location | 2583 Turpins Glen Dr, Germantown, Tennessee |
| Authorized Official Name and Position | Kimberly H Dafferner (CO-OWNER/FOUNDER) |
| Authorized Official Contact | 9013180506 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Therapy Group 2583 Turpins Glen Dr Germantown TN 38138-5820 Ph: (901) 318-0506 | Restore Therapy Group 2583 Turpins Glen Dr Germantown TN 38138-5820 Ph: (901) 318-0506 |
| NPI Number | 1740066331 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Medicare PECOS PAC ID | 5294184552 |
|---|---|
| Medicare Enrollment ID | O20231212001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740066331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelley Catherine Lewin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851777270 PECOS PAC ID: 4688078231 Enrollment ID: I20210804003056 |
| Provider Name | Kimberly H Dafferner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427698323 PECOS PAC ID: 7012374226 Enrollment ID: I20230602001697 |
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