Provider Demographics
NPI:1871785139
Name:BILLIE, RENEE A (PT)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:A
Last Name:BILLIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CLINTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:TRIADELPHIA
Mailing Address - State:WV
Mailing Address - Zip Code:26059
Mailing Address - Country:US
Mailing Address - Phone:304-243-4927
Mailing Address - Fax:304-243-4927
Practice Address - Street 1:58 16TH STREET
Practice Address - Street 2:5TH FLOOR VNA OF MEDICAL PARK
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-243-4663
Practice Address - Fax:304-243-7175
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV001109225100000X
OHPT011600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist