Healthcare Provider Details

I. General information

NPI: 1306068531
Provider Name (Legal Business Name): RENAISSANCE SLEEP CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 WINCHESTER AVE SUITE 2
ASHLAND KY
41101-1962
US

IV. Provider business mailing address

2920 WINCHESTER AVE SUITE 2
ASHLAND KY
41101-1962
US

V. Phone/Fax

Practice location:
  • Phone: 606-920-9966
  • Fax: 606-920-9965
Mailing address:
  • Phone: 606-920-9966
  • Fax: 606-920-9965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. CURTIS RAY NICHOLS
Title or Position: OWNER
Credential:
Phone: 606-920-9966