Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT00010379 | WA |
Y | 2251G0304X | Physical Therapist - Geriatrics | 2008026063 | MO |
NPI | 1275738932 |
---|---|
Provider Name | Ms. Renee Christine Springer |
First Address | Kansas City, MO 64155-3601 |
Second Address | Gladstone, MO 64119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 15/06/2018 |