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Individual
MR. MARK REX MAHNENSMITH
Active
Individual
MR. MARK REX MAHNENSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0400090284
VT
225100000X
Physical Therapist
2305206947
VA
225100000X
Physical Therapist
3680
NH
225100000X
Physical Therapist
Primary
PT02905
RI
Other
Enumeration date
06/23/2011
Last updated
06/13/2016
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