Provider Demographics
NPI:1982850335
Name:RENTON, ELEANOR (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:
Last Name:RENTON
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:RR 3 BOX 338B
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-9423
Mailing Address - Country:US
Mailing Address - Phone:304-366-1299
Mailing Address - Fax:304-366-9380
Practice Address - Street 1:RR 3 BOX 338B
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-9423
Practice Address - Country:US
Practice Address - Phone:304-366-1299
Practice Address - Fax:304-366-9380
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV28225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist