Organization
RENEW PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW RIEDER DPT (OWNER)
(904) 599-5459
Entity
Organization
Contact information
Practice address
424 GENTIAN RD, ST AUGUSTINE, FL 32086-6426
(904) 599-5459
Mailing address
424 GENTIAN RD, ST AUGUSTINE, FL 32086-6426
(904) 599-5459
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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