Provider Demographics
NPI:1134744550
Name:ISAAC, RENEE JOY (ATC,LAT)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:JOY
Last Name:ISAAC
Suffix:
Gender:F
Credentials:ATC,LAT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC,LAT
Mailing Address - Street 1:1 WOODLAND TER
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-1232
Mailing Address - Country:US
Mailing Address - Phone:412-365-1470
Mailing Address - Fax:
Practice Address - Street 1:1 WOODLAND TER
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15229-1232
Practice Address - Country:US
Practice Address - Phone:412-365-1470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0045462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer