| NPI | 1417530593 |
|---|---|
| Doing Business As | RESTOREDOC MD |
| Doing Business As | LIFERESTORE MD USA LLC |
| Entity Type | Organization |
| Authorized Contact | BOB OLOVSSON COO 214-494-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2021-05-05 |