Provider Demographics
NPI:1154598167
Name:RINEARSON, RENA KAY
Entity type:Individual
Prefix:MS
First Name:RENA
Middle Name:KAY
Last Name:RINEARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 CAPITAL AVE NE
Mailing Address - Street 2:STE. 110
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-5308
Mailing Address - Country:US
Mailing Address - Phone:269-660-8566
Mailing Address - Fax:269-660-8566
Practice Address - Street 1:1504 CAPITAL AVE NE
Practice Address - Street 2:STE. 110
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-5308
Practice Address - Country:US
Practice Address - Phone:269-660-8566
Practice Address - Fax:269-660-8566
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2706123902225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist