Provider Demographics
NPI:1871754010
Name:CASADY, RENEE LYNN (PT MS)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:CASADY
Suffix:
Gender:F
Credentials:PT MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7403 COUNTY ROAD 101
Mailing Address - Street 2:
Mailing Address - City:BELLE CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43310-9532
Mailing Address - Country:US
Mailing Address - Phone:937-935-2594
Mailing Address - Fax:
Practice Address - Street 1:7403 COUNTY ROAD 101
Practice Address - Street 2:
Practice Address - City:BELLE CENTER
Practice Address - State:OH
Practice Address - Zip Code:43310-9532
Practice Address - Country:US
Practice Address - Phone:937-935-2594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4436225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist