Restore of Arizona

NPI #1760822662 in Glendale, Arizona

Provider Information

NPI Number: 1760822662
Entity Type: Organization
Organization Name: Restore of Arizona
Primary Specialty: Specialist
Enumeration Date: Jun 25, 2013
Last Updated: Jun 25, 2013

Practice Location

Address: 17431 N 71ST DR
Address 2: SUITE 104
City: Glendale
State: Arizona
ZIP Code: 85308-8598
Phone: (623) 209-5067

Authorized Official

Name: MRS. AMY BODE
Title: MANAGING PARTNER
Phone: (623) 209-5067

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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