Provider Demographics
NPI:1710023957
Name:TORNATORE, RENEE A (DC)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:A
Last Name:TORNATORE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221273
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40252-1273
Mailing Address - Country:US
Mailing Address - Phone:812-734-1020
Mailing Address - Fax:812-225-5145
Practice Address - Street 1:2230 EDSEL LN NW STE 1
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2136
Practice Address - Country:US
Practice Address - Phone:812-734-1020
Practice Address - Fax:812-225-5145
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001935A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000293597OtherANTHEM BCBS
7697812OtherCIGNA
P00107238OtherRAILROAD MEDICARE
IN200291490Medicaid
P00107238OtherRAILROAD MEDICARE
U80709Medicare UPIN