Provider Demographics
NPI:1679536833
Name:MANSELL, RALPH CHRISTOPHER (MED, ATC)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:CHRISTOPHER
Last Name:MANSELL
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:101 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06268-2329
Mailing Address - Country:US
Mailing Address - Phone:860-487-0142
Mailing Address - Fax:
Practice Address - Street 1:2111 HILLSIDE ROAD
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06269-3078
Practice Address - Country:US
Practice Address - Phone:860-486-3046
Practice Address - Fax:860-486-5277
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer