Individual
RENITA SUMMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9004 E 74TH TER, RAYTOWN, MO 64133-6433
(816) 256-0786
Mailing address
9004 E 74TH TER, RAYTOWN, MO 64133-6433
(816) 256-0786
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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