Organization
RENOVA PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILTON DE BRUN D.P.T (DIRECTOR)
(404) 797-5058
Entity
Organization
Contact information
Practice address
5515 WARRENSBURG RD, GREENEVILLE, TN 37743-3282
(423) 788-5106
Mailing address
1113 TUSCULUM BLVD # 104, GREENEVILLE, TN 37745-4038
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/26/2023
Last updated
01/06/2025
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