Provider Demographics
NPI:1518911197
Name:HANDWERGER, RONNIE (PT)
Entity Type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:
Last Name:HANDWERGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3909
Mailing Address - Country:US
Mailing Address - Phone:251-344-4468
Mailing Address - Fax:251-344-4423
Practice Address - Street 1:861 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-3909
Practice Address - Country:US
Practice Address - Phone:251-344-4468
Practice Address - Fax:251-344-4423
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALR35713Medicare UPIN
AL70501Medicare ID - Type UnspecifiedPROVIDER NUMBER