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NPI Code Detail

MEDICARE: JULIE RENNER PT

MEDICARE: JULIE RENNER PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist013311OH

General Provider Information

NPI Number : 1679931240
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE RENNER PT
Provider Business Mailing Address
First Line : 1100 SHAWNEE RD
Second Line :
City : LIMA
State : OH
Zip : 45805-3583
Country : US
Telephone Number : 419-999-2010
Fax Number : 419-999-6284
Provider Business Practice Location Address
First Line : 2651 FORT AMANDA RD
Second Line :
City : LIMA
State : OH
Zip : 45804-3730
Country : US
Telephone Number : 419-228-8412
Fax Number : 419-228-8612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2016
Last Update Date : 08/11/2021

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