MEDICARE: RENEW PHYSIOTHERAPY

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
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1558857490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEW PHYSIOTHERAPY

Provider Business Mailing Address
First Line	:	3480 SPRING HILL AVE
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-1523
Country	:	US
Telephone Number	:	251-589-6642
Fax Number	:

Provider Business Practice Location Address
First Line	:	3480 SPRING HILL AVE
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-1523
Country	:	US
Telephone Number	:	251-589-6642
Fax Number	:	251-589-6150

Authorized Official
Title or Position	:	DOO
Name	:	TARA JEWEL JONES
Credential	:
Telephone Number	:	251-605-2482

Provider Enumeration Date	:	07/03/2018
Last Update Date	:	04/07/2021

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Directions to “RENEW PHYSIOTHERAPY ” Practice Location

Language	Start Address	Practice Location

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