Provider Demographics
NPI:1417199449
Name:RENOMERON, JOHN RYAN M (PT)
Entity Type:Individual
Prefix:
First Name:JOHN RYAN
Middle Name:M
Last Name:RENOMERON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 BARLEY RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-2223
Mailing Address - Country:US
Mailing Address - Phone:717-767-6530
Mailing Address - Fax:
Practice Address - Street 1:1770 BARLEY RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-2223
Practice Address - Country:US
Practice Address - Phone:717-767-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist