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Individual
RENEE THRELFALL
Active
Individual
RENEE THRELFALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
010474
GA
225100000X
Physical Therapist
Primary
2305206415
VA
225100000X
Physical Therapist
2831
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003120150A
—
GA
01
—
00800698
AMERIGROUP
GA
01
—
08Y004741NH01
ANTHEM
NH
05
—
30392274
—
NH
Enumeration date
02/14/2006
Last updated
02/18/2014
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