Provider Demographics
NPI:1982040267
Name:MAAS, RENAE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RENAE
Middle Name:
Last Name:MAAS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 S GLENVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4939
Mailing Address - Country:US
Mailing Address - Phone:515-285-2559
Mailing Address - Fax:515-285-6487
Practice Address - Street 1:1000 N WEST AVE STE 210
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1314
Practice Address - Country:US
Practice Address - Phone:605-332-1058
Practice Address - Fax:605-575-0321
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist