Provider Demographics
NPI:1730163486
Name:RENTCHLER, CHERYL SUE (MPT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:SUE
Last Name:RENTCHLER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5629
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5629
Mailing Address - Country:US
Mailing Address - Phone:812-476-0409
Mailing Address - Fax:812-476-1016
Practice Address - Street 1:5625 PEARL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-8106
Practice Address - Country:US
Practice Address - Phone:812-759-7493
Practice Address - Fax:812-401-2346
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007888A225100000X
KY005466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000646118OtherBLUE CROSS BLUE SHIELD
IN000000280224OtherBLUE CROSS BLUE SHIELD
IN200818540Medicaid
IN200818540Medicaid
IN000000646118OtherBLUE CROSS BLUE SHIELD
IN255480WWMedicare PIN
IN000000280224OtherBLUE CROSS BLUE SHIELD
IN216070WWMedicare PIN