MEDICARE: RENEE HELMKAMP

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
1	2251P0200X	Pediatric Physical Therapist	05004567A	IN

General Provider Information

NPI Number	:	1720341050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE HELMKAMP

Provider Business Mailing Address
First Line	:	808 MILL LAKE RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-6400
Country	:	US
Telephone Number	:	260-338-1241
Fax Number	:	260-338-1231

Provider Business Practice Location Address
First Line	:	4935 HILLEGAS RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46818-1934
Country	:	US
Telephone Number	:	260-338-1241
Fax Number	:	260-338-1231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	03/16/2017

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Directions to “ RENEE HELMKAMP ” Practice Location

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