Provider Demographics
NPI:1124709290
Name:RESTORE HEALTH & PAIN TREATMENT GROUP PLLC
Entity type:Organization
Organization Name:RESTORE HEALTH & PAIN TREATMENT GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO/COO
Authorized Official - Prefix:
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:509-824-6080
Mailing Address - Street 1:8524 W GAGE BLVD SUITE A-1#355
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336
Mailing Address - Country:US
Mailing Address - Phone:509-824-6080
Mailing Address - Fax:
Practice Address - Street 1:1601 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2427
Practice Address - Country:US
Practice Address - Phone:509-824-6080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty