Provider Demographics
NPI:1053935403
Name:INFANTINO, RONALD PAUL
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:PAUL
Last Name:INFANTINO
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 1:2810 W US HIGHWAY 64 STE 1
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-4061
Mailing Address - Country:US
Mailing Address - Phone:828-837-0400
Mailing Address - Fax:828-837-0404
Practice Address - Street 1:2810 W US HIGHWAY 64 STE 1
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-4061
Practice Address - Country:US
Practice Address - Phone:828-837-0400
Practice Address - Fax:828-837-0404
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA5675225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant