National Provider Identifier Database

RESTORE VITALITY CENTER
Addiction Medicine

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.


Contact Information

RESTORE VITALITY CENTER
8133 W HEATHERBRAE DR
PHOENIX, AZ85033-2336
Phone: 602-814-2559
Fax:
Website:
Specialty Taxonomy Code
* Addiction Medicine 207RA0401X
Electrodiagnostic Medicine 204R00000X
Endocrinology, Diabetes & Metabolism 207RE0101X
Gastroenterology 207RG0100X
Neuromuscular Medicine 2081N0008X
Nutrition, Education 133NN1002X

* Indicates primary specialty

NPI Profile & details for RESTORE VITALITY CENTER

NPI Number 1447767181
Legal business name
LBN
RESTORE VITALITY CENTER
Authorized official MICHAEL NELSON - (OWNER/MEMBER)
Entity Organization
Organization subpart No
Enumeration date 01/03/2018
Last updated 01/03/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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