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Individual
MR. PAUL HENRY RENNER
Active
Individual
MR. PAUL HENRY RENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT001766
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0470075
—
OH
01
—
CM0529
MEDICARE ID TYPE UNSPEC
OH
Enumeration date
03/31/2006
Last updated
07/15/2013
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