Healthcare Provider Details

I. General information

NPI: 1083301360
Provider Name (Legal Business Name): JESSIE RINDERKNECHT RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4646 JOHN R ST
DETROIT MI
48201-1916
US

IV. Provider business mailing address

20160 HOLIDAY RD
GROSSE POINTE WOODS MI
48236-1804
US

V. Phone/Fax

Practice location:
  • Phone: 313-576-3338
  • Fax:
Mailing address:
  • Phone: 734-363-5295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: