Provider Demographics
NPI:1366474140
Name:EYNAUD, RONALD (MSPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:EYNAUD
Suffix:
Gender:M
Credentials:MSPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 W WALNUT AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-6233
Mailing Address - Country:US
Mailing Address - Phone:559-636-1200
Mailing Address - Fax:
Practice Address - Street 1:1730 W WALNUT AVE
Practice Address - Street 2:STE. B
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6233
Practice Address - Country:US
Practice Address - Phone:559-636-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24428225100000X
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ20976ZMedicare ID - Type Unspecified