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General NPI Number Information
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NPI Number | 1336712660
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Entity Type | Organization
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Legal Business Name | RENEWAL PHYSICAL THERAPY PLC
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 53 RAILROAD ST UNIT 1
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City | RICHMOND
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State | VT
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Zip | 05477-7749
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Country | US
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Telephone | 845-594-9718
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 180
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City | HUNTINGTON
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State | VT
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Zip | 05462-0180
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Country | US
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Telephone | 845-594-9718
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | KALEIGH MULPETER
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Credential | PT, DPT
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Telephone | 845-594-9718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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