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General NPI Number Information
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NPI Number | 1831782721
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Entity Type | Individual
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Provider Name | LAURA A RENAUD MPT
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Gender | Female
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 02/11/2021
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Provider Practice Location Address
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Address Line | 1000 NORTH ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-1585
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Country | US
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Telephone | 413-499-7186
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Fax |
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Provider Business Mailing Address
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Address Line | 134 MOREAU DR
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City | CHICOPEE
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State | MA
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Zip | 01020-4829
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Country | US
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Telephone | 413-222-8920
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17813
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License Number State | MA
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