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NPI Code Detail

MEDICARE: JENNIFER RENO-FOWLER

MEDICARE: JENNIFER RENO-FOWLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501302288MI

General Provider Information

NPI Number : 1144926551
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RENO-FOWLER
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number : 586-350-2644
Fax Number : 586-541-3735
Provider Business Practice Location Address
First Line : 36880 WOODWARD AVE STE 102
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48304-0920
Country : US
Telephone Number : 248-480-7440
Fax Number : 248-480-7441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2023
Last Update Date : 12/18/2024

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Directions to “ JENNIFER RENO-FOWLER ” Practice Location

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