Restivo, Mark
Restivo, Mark is an sole proprietor health care provider with primary practice located at 101 Cedar Rock Trace Www.Chiropracticworks.Com/, Athens GA 30605-3217. He recently has only one registered license in Chiropractic Providers / Rehabilitation, which is considered as his primary health care specialty. Restivo, Mark can be contacted via phone (706) 367-1208.Contact Information
Primary practice address
101 Cedar Rock Trace Www.Chiropracticworks.Com/
Athens GA 30605-3217
Phone: (706) 367-1208
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Rehabilitation | 111NR0400X | CHIROO7190 | Georgia |
Profile Details
| NPI number | 1588877468 |
|---|---|
| LBN Legal business name | Restivo, Mark |
| Credentials | DC NMT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 8th, 2007 |
| Last updated | Nov 30th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588877468 | NPPES |
| Georgia | Other | 010736948 | SECONDARY TAX ID |
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