Renew Home Therapy Pllc | |
6051 Bradford St, Portage, MI 49024-2553 | |
(269) 903-9737 | |
Not Available |
Full Name | Renew Home Therapy Pllc |
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Type | Facility |
Speciality | Occupational Therapist - Gerontology |
Location | 6051 Bradford St, Portage, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255117453 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225XG0600X | Occupational Therapist - Gerontology | (* (Not Available)) | Primary |
Provider Name | Cassandra M Jennings |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1124594924 PECOS PAC ID: 2769864149 Enrollment ID: I20220802000501 |
Mailing Address | Practice Location Address |
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Renew Home Therapy Pllc 6051 Bradford St, Portage, MI 49024-2553 Ph: () - | Renew Home Therapy Pllc 6051 Bradford St, Portage, MI 49024-2553 Ph: (269) 903-9737 |
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