Provider Demographics
NPI:1629831342
Name:CEBULA, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:CEBULA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 TALISMAN LN
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1843
Mailing Address - Country:US
Mailing Address - Phone:724-679-1114
Mailing Address - Fax:
Practice Address - Street 1:333 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAXONBURG
Practice Address - State:PA
Practice Address - Zip Code:16056-2254
Practice Address - Country:US
Practice Address - Phone:724-352-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist