Provider Demographics
NPI:1053873364
Name:MUFFULETTO, RONALD WILLIAM JR (PT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WILLIAM
Last Name:MUFFULETTO
Suffix:JR
Gender:M
Credentials:PT
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Mailing Address - Street 1:5703 GULF TECH DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-8238
Mailing Address - Country:US
Mailing Address - Phone:228-875-5447
Mailing Address - Fax:228-875-5448
Practice Address - Street 1:8905 OCEAN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-4419
Practice Address - Country:US
Practice Address - Phone:228-215-0521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSPT3702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist