Provider Demographics
NPI:1376744573
Name:RENCH, KRISTOPHER JOSEPH (OTR)
Entity Type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:JOSEPH
Last Name:RENCH
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 REDFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-4809
Mailing Address - Country:US
Mailing Address - Phone:603-434-7525
Mailing Address - Fax:
Practice Address - Street 1:12 WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2916
Practice Address - Country:US
Practice Address - Phone:978-458-1271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8530225X00000X
NH1723225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist