Organization Name: | REST-MOORE INC. |
NPI Number: | 1467825182 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MORGAN MIRACLE (PRESIDENT/OWNER) |
Mailing Address: | 1632 Cumberland Ave Suite 1 Middlesboro |
State: | KY US |
Postal Code: | 409651378 |
Phone Number: | 6063024309 |
Fax Number: | 6067660808 |
NPI Enumeration Date: | 11/03/2015 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |