| Doctor Name: | MRS. RENEE MARIE RICHARDSON |
| NPI Number: | 1700071255 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT,MPT |
| License Number: | T6330 |
| Business Practice Address: | 1603 Georgia Highway 20 Ne Conyers, GA - 300123945 |
| Business Phone Number: | 7709298411 |
| Business Fax Number: | 7709181419 |
| Mailing Address: | 1603 Georgia Highway 20 Ne, CONYERS |
| State: | GA |
| Postal Code: | 300123945 |
| Phone Number: | 7709298411 |
| Fax Number: | 7709181419 |
| NPI Enumeration Date: | 09/07/2007 |
| NPI Last Update Date: | 12/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | T6330 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |