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NPI Code Detail

MEDICARE: RENLEY LLC

MEDICARE: RENLEY LLC
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1821596784
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENLEY LLC
Provider Business Mailing Address
First Line : 2925 VIRGINIA DALE DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-4034
Country : US
Telephone Number : 505-787-4864
Fax Number :
Provider Business Practice Location Address
First Line : 2925 VIRGINIA DALE DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-4034
Country : US
Telephone Number : 505-787-4864
Fax Number :
Authorized Official
Title or Position : OWNER
Name : NATHAN RENLEY
Credential : M.S., CCC-SLP
Telephone Number : 505-787-4861
Provider Enumeration Date : 01/25/2018
Last Update Date : 01/05/2019

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Directions to “RENLEY LLC ” Practice Location

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