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NPI 1477364214

NPI 1477364214 : RENEE RIEDEL LMT : OVERLAND PARK, KS

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General NPI Number Information
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    NPI Number           |    1477364214
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    Entity Type          |    Individual 
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    Provider Name        |    RENEE RIEDEL LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/20/2025
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    Last Update Date     |    01/20/2025
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Provider Practice Location Address
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    Address Line         |    9270 METCALF AVE. SUITE 118
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    City                 |    OVERLAND PARK
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    State                |    KS
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    Zip                  |    66212-1478
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    Country              |    US
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    Telephone            |    913-543-1177
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8804 W 88TH ST 
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    City                 |    OVERLAND PARK
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    State                |    KS
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    Zip                  |    66212-3610
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    Country              |    US
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    Telephone            |    913-271-4069
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    THR-068271
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    License Number State |    KS
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