Organization
RENEGADE WAREHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHELSEA MARIE MUNCY PTA (HEAD OWNER)
(937) 694-6226
Entity
Organization
Contact information
Practice address
10841 WOOD RD, MIAMISBURG, OH 45342
(937) 694-6226
Mailing address
1061 DECKER DR, MIAMISBURG, OH 45342-6415
(937) 694-6226
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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