| Restore Dme Medical Group, Llc | |
| 
					6410 S Kings Ranch Rd Ste 1 Gold Canyon AZ 85118-7352  | |
| (480) 689-9205 | |
| (480) 288-2879 | 
| Full Name | Restore Dme Medical Group, Llc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 6410 S Kings Ranch Rd, Gold Canyon, Arizona | 
| Authorized Official Name and Position | Robert Christiaan Allen (OWNER) | 
| Authorized Official Contact | 4806899205 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Restore Dme Medical Group, Llc 6410 S Kings Ranch Rd Ste 1 Gold Canyon AZ 85118-7352 Ph: (480) 689-9205  | Restore Dme Medical Group, Llc 6410 S Kings Ranch Rd Ste 1 Gold Canyon AZ 85118-7352 Ph: (480) 689-9205  | 
| NPI Number | 1104287697 | 
|---|---|
| Provider Enumeration Date | 03/11/2016 | 
| Last Update Date | 03/11/2016 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1104287697 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 30153 (Arizona) | Primary | 
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