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General NPI Number Information
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NPI Number | 1538449822
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Entity Type | Individual
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Provider Name | RENEE KING DPT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2011
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 220 CENTER ST UNIT 16
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City | PEMBROKE
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State | MA
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Zip | 02359-2656
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Country | US
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Telephone | 508-742-9472
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Fax | 774-221-2205
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Provider Business Mailing Address
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Address Line | 1 CREDIT UNION WAY FL 3
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City | RANDOLPH
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State | MA
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Zip | 02368-4633
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Country | US
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Telephone | 781-961-3370
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Fax | 781-961-1291
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 19147
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License Number State | MA
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