Individual
MS. RENEE A IVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4240 DUNCAN AVE, DEPT PHYSICAL THERAPY, STE 120, SAINT LOUIS, MO 63110-1101
(314) 286-1940
(314) 286-1473
Mailing address
PO BOX 60352, SAINT LOUIS, MO 63160-0352
(314) 286-1940
(314) 286-1473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01496
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480057362
—
MO
Enumeration date
07/14/2006
Last updated
04/25/2024
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