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Individual

MS. RENATA STURDIVANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S., RRT

Contact information

Practice address
7503 RIVERSIDE PARK DR, SAN ANTONIO, TX 78249-4324
(309) 258-1194
Mailing address
3516 W MARY KNOLL CT, PEORIA, IL 61615-3727
(309) 258-1194

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
227900000X
Registered Respiratory Therapist
Primary

Other

Enumeration date
02/25/2011
Last updated
02/25/2011
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