OrganizationActive
Restoration Wellness, LLC
NPI 1962953810 · Primary Care Clinic/Center · Wasilla, AK
Provider details
- NPI number
- 1962953810
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Lydia Petersen, Owner(907) 376-7300
- License
- 1042971 (AK)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
5805 E Columbus Way
Wasilla, AK 99654-7831
Phone: (907) 376-7300
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 876089
Wasilla, AK 99687-6089
Registry dates
- Enumerated
- 2016-10-16
- Last updated
- 2016-12-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.