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General NPI Number Information
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NPI Number | 1992089486
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Entity Type | Organization
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Legal Business Name | RENAISSANCE REHAB CLINIC LLC
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 5322 E US HIGHWAY 83 STE 3C
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-9462
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Country | US
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Telephone | 956-263-1054
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Fax | 956-682-1829
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Provider Business Mailing Address
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Address Line | 5322 E HWY 83 STE C-3
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-9426
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Country | US
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Telephone | 956-263-1054
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Fax | 956-682-1829
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Authorized Official
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Title or Position | OWNER
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Name | DR. AARON R GUERRA
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Credential | D.C.
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Telephone | 956-263-1054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10027
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License Number State | TX
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