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General NPI Number Information
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NPI Number | 1730790064
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Entity Type | Individual
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Provider Name | RENEA REDDING OTC, MA-C
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Gender | Female
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 4140 CENTENNIAL HILLS BLVD
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City | CASPER
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State | WY
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Zip | 82609-3265
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Country | US
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Telephone | 307-265-7205
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Fax | 307-235-6262
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Provider Business Mailing Address
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Address Line | 4140 CENTENNIAL HILLS BLVD
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City | CASPER
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State | WY
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Zip | 82609-3265
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Country | US
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Telephone | 307-265-7205
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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 | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 20-0611
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License Number State | WY
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