Provider Demographics
NPI:1417605627
Name:MESTNIK, SHAUNA (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:
Last Name:MESTNIK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 ALDERSYDE CIR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-2085
Mailing Address - Country:US
Mailing Address - Phone:440-823-3608
Mailing Address - Fax:
Practice Address - Street 1:7055 ENGLE RD STE 503
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-8456
Practice Address - Country:US
Practice Address - Phone:440-816-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT9061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist