| Restoration Wellness, Llc | |
|
5805 E Columbus Way Wasilla AK 99654-7831 | |
| (907) 376-7300 | |
| Not Available |
| Full Name | Restoration Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5805 E Columbus Way, Wasilla, Alaska |
| Authorized Official Name and Position | Lydia M Petersen (OWNER) |
| Authorized Official Contact | 9073767300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration Wellness, Llc Po Box 876089 Wasilla AK 99687-6089 Ph: (907) 376-7300 | Restoration Wellness, Llc 5805 E Columbus Way Wasilla AK 99654-7831 Ph: (907) 376-7300 |
| NPI Number | 1962953810 |
|---|---|
| Provider Enumeration Date | 10/16/2016 |
| Last Update Date | 12/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962953810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 1042971 (Alaska) | Primary |
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