Provider Demographics
NPI:1336712660
Name:RENEWAL PHYSICAL THERAPY PLC
Entity Type:Organization
Organization Name:RENEWAL PHYSICAL THERAPY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:KALEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:MULPETER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:845-594-9718
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05462-0180
Mailing Address - Country:US
Mailing Address - Phone:845-594-9718
Mailing Address - Fax:
Practice Address - Street 1:53 RAILROAD ST UNIT 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VT
Practice Address - Zip Code:05477-7749
Practice Address - Country:US
Practice Address - Phone:845-594-9718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy