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Organization
INNOVATIVE RENEWAL THERAPY CENTER LLC
Active
Organization
INNOVATIVE RENEWAL THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWANA COTTMAN (OWNER)
(804) 657-7344
Entity
Organization
Contact information
Practice address
73 MARKET ST, ONANCOCK, VA 23417-4223
(804) 657-7344
Mailing address
73 MARKET ST, ONANCOCK, VA 23417-4223
(804) 657-7344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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