Provider Demographics
NPI:1730308859
Name:HILL, RENEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 KALAMAZOO AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4625
Mailing Address - Country:US
Mailing Address - Phone:616-281-0666
Mailing Address - Fax:616-281-0752
Practice Address - Street 1:4540 KALAMAZOO AVE SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4625
Practice Address - Country:US
Practice Address - Phone:616-281-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICI2694OtherMEDICARE RAILROAD
MI1730308859Medicaid
MI0M71140Medicare PIN