Provider Demographics
NPI:1861213084
Name:RELEASE AND RESTORE LLC
Entity type:Organization
Organization Name:RELEASE AND RESTORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOC
Authorized Official - Prefix:
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEHL HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-209-7416
Mailing Address - Street 1:4738 CHARING CROSS CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-6236
Mailing Address - Country:US
Mailing Address - Phone:715-209-7416
Mailing Address - Fax:
Practice Address - Street 1:2840 PROCTOR RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6444
Practice Address - Country:US
Practice Address - Phone:941-529-5995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center