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Organization
RENEGADE MOVEMENT AND PERFORMANCE, LLC
Active
Organization
RENEGADE MOVEMENT AND PERFORMANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS BRUNELLE PT, DPT (PHYSICAL THERAPIST, CO-OWNER)
(315) 573-0705
Entity
Organization
Contact information
Practice address
10 COMMERCE PARK N STE 7B, BEDFORD, NH 03110-6907
(603) 267-0432
Mailing address
195 MCGREGOR ST APT 414, MANCHESTER, NH 03102-3777
(315) 573-0705
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/06/2020
Last updated
06/15/2022
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