Provider Demographics
NPI:1851515712
Name:NETTER, RENEE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:NETTER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MEANDER WAY
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-8533
Mailing Address - Country:US
Mailing Address - Phone:317-409-3285
Mailing Address - Fax:317-888-9679
Practice Address - Street 1:112 MEANDER WAY
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-8533
Practice Address - Country:US
Practice Address - Phone:317-409-3285
Practice Address - Fax:317-888-9679
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006983A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist