Provider Demographics
NPI:1295147296
Name:RESNGIT, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:RESNGIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 ELDERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-6369
Mailing Address - Country:US
Mailing Address - Phone:828-252-1790
Mailing Address - Fax:
Practice Address - Street 1:415 ELDERBERRY LN
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-6369
Practice Address - Country:US
Practice Address - Phone:828-252-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-24
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist