# RENEW PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699967992
- **Authorized official:** MR. VICTOR J VARISCO O.T. (MANAGING MEMBER)
- **Authorized official phone:** (337) 233-7701

## Contact information

- **Practice address:** 19345 SUNSHINE AVENUE, COVINGTON, LA 70433
- **Practice address phone:** (985) 809-3940
- **Practice address fax:** (985) 809-3942
- **Mailing address:** 19345 SUNSHINE AVENUE, SUITE A, COVINGTON, LA 70433-8720
- **Mailing address phone:** (985) 809-3940
- **Mailing address fax:** (985) 809-3942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2007
- **Last updated:** 04/06/2011