Provider Demographics
NPI:1720756158
Name:RESTORE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:RESTORE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SADDHRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:540-467-5789
Mailing Address - Street 1:2125 E WASHINGTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179-4601
Mailing Address - Country:US
Mailing Address - Phone:540-647-8331
Mailing Address - Fax:540-491-9737
Practice Address - Street 1:2125 E WASHINGTON AVE STE C
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:VA
Practice Address - Zip Code:24179-4601
Practice Address - Country:US
Practice Address - Phone:540-647-8331
Practice Address - Fax:540-491-9737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)