Individual
MATTHEW EDWARD RENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6744 CLAYTON RD, SUITE 220, SAINT LOUIS, MO 63117-1637
(314) 644-1978
(314) 647-1350
Mailing address
6744 CLAYTON RD, SUITE 220, SAINT LOUIS, MO 63117-1637
(314) 644-1978
(314) 647-1350
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2007008752
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120764
BCBS-MO
MO
01
—
481617
HEALTHLINK
MO
Enumeration date
06/03/2008
Last updated
06/03/2008
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