Individual
EDWARD RENEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
517 S MILDRED ST, CHARLES TOWN, WV 25414-1331
(703) 371-6287
Mailing address
517 S MILDRED ST, CHARLES TOWN, WV 25414-1331
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000148
VA
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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