Provider Demographics
NPI:1700108503
Name:REMINGTON, DAWN RENAE (COTA, C,M,T)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:RENAE
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:COTA, C,M,T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 BRISTLEHILL DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8902
Mailing Address - Country:US
Mailing Address - Phone:616-522-9330
Mailing Address - Fax:
Practice Address - Street 1:3751 S STATE RD
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-9478
Practice Address - Country:US
Practice Address - Phone:616-522-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist