Provider Demographics
NPI:1902513443
Name:RENEWED STRENGTH, LLC
Entity Type:Organization
Organization Name:RENEWED STRENGTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:620-433-0459
Mailing Address - Street 1:3510 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-3239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3510 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-3239
Practice Address - Country:US
Practice Address - Phone:620-433-0459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy