Provider Demographics
NPI:1639834377
Name:RENAISSANCE INTERNATIONAL CORP.
Entity Type:Organization
Organization Name:RENAISSANCE INTERNATIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:II
Authorized Official - Credentials:BCTMB
Authorized Official - Phone:978-465-5111
Mailing Address - Street 1:204 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3824
Mailing Address - Country:US
Mailing Address - Phone:978-465-5111
Mailing Address - Fax:206-202-3534
Practice Address - Street 1:10 PRINCE PL STE 112
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2641
Practice Address - Country:US
Practice Address - Phone:978-465-5111
Practice Address - Fax:206-202-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty