Provider Demographics
NPI:1053579623
Name:RENSEL, NATALIE MARIE (PTA)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:MARIE
Last Name:RENSEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1229
Mailing Address - Country:US
Mailing Address - Phone:814-371-4058
Mailing Address - Fax:
Practice Address - Street 1:15 REYNOLDS AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1229
Practice Address - Country:US
Practice Address - Phone:814-371-4058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE005462L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant