Provider Demographics
NPI:1063966604
Name:LEOPOLD, RENEE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:LEOPOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:KARHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8659 ROAD 12
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-9614
Mailing Address - Country:US
Mailing Address - Phone:419-890-8044
Mailing Address - Fax:
Practice Address - Street 1:1331 E 4TH ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-1505
Practice Address - Country:US
Practice Address - Phone:419-523-9337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10627225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant