Restoration Body Works Wellness and Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2093 Issued in AZ

Legal business name

RESTORATION BODY WORKS WELLNESS AND PHYSICAL THERAPY, PLLC

Doing business as

Restoration Body Works Wellness and Physical Therapy PLLC

Practice address

710 N Beaver St BLDG 6
Flagstaff, AZ 86001-3148

Phone

(928) 213-9730

Fax

(928) 213-9732

NPI assigned

Sep 27, 2007

Last updated

Jan 4, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elvia Cuevas

Title

Office Manager

Phone

(928) 213-9730

Specialties & licenses 1

Addresses

Other names 2

• Restoration Body Works Wellness and Physical Therapy PLLC Doing business as
• Mari Dieckman Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lita Byerly, PT

  • Specialist
  • Flagstaff, AZ
  • NPI 1255564027

  Physical Therapist

  NPD (past)
• Kyndall L Boyle, PT, PHD, OCS, PRC

  • Physical Therapist
  • Boone, NC
  • NPI 1740466721

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1689861288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N BEAVER ST BLDG 6",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013148",
            "telephone_number": "928-213-9730",
            "fax_number": "928-213-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N BEAVER ST BLDG 6",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013148",
            "telephone_number": "928-213-9730",
            "fax_number": "928-213-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION BODY WORKS WELLNESS AND PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "ELVIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-213-9730"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Body Works Wellness and Physical Therapy PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mari Dieckman",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Cassandra Jean Reynolds, RD
• Kali Reynolds, BS SLPA
• Nichole Michelle Reynolds

• Physical Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.