Provider Demographics
NPI:1003471137
Name:HOGUE, RENEE (DPT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:HOGUE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:DIANE
Other - Last Name:GAGNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2860
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88311-2860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 W MAHONE DR
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-2046
Practice Address - Country:US
Practice Address - Phone:575-746-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT5475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist