Provider Demographics
NPI:1063844769
Name:MASHNI, RONALD D (DPT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:D
Last Name:MASHNI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 N. TELEGRAPH ROAD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3368
Mailing Address - Country:US
Mailing Address - Phone:734-243-0300
Mailing Address - Fax:734-243-3066
Practice Address - Street 1:1291 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3368
Practice Address - Country:US
Practice Address - Phone:734-243-0300
Practice Address - Fax:734-243-3066
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010159902251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic