Provider Demographics
NPI:1104517663
Name:RESTOREOT, INC.
Entity type:Organization
Organization Name:RESTOREOT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:310-855-4166
Mailing Address - Street 1:26961 BASSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-2271
Mailing Address - Country:US
Mailing Address - Phone:310-488-3426
Mailing Address - Fax:
Practice Address - Street 1:26961 BASSWOOD AVE
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-2271
Practice Address - Country:US
Practice Address - Phone:310-488-3426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty