Provider Demographics
NPI:1245909712
Name:RENTEL, WILLIAM RALPH III (OTR/L D/PAM)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RALPH
Last Name:RENTEL
Suffix:III
Gender:M
Credentials:OTR/L D/PAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 CEDAR CREEK RD APT 11
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1415
Mailing Address - Country:US
Mailing Address - Phone:423-794-6227
Mailing Address - Fax:
Practice Address - Street 1:945 W RUSSELL ST
Practice Address - Street 2:
Practice Address - City:ELKHORN CITY
Practice Address - State:KY
Practice Address - Zip Code:41522-9032
Practice Address - Country:US
Practice Address - Phone:844-334-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY262588225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist