| Doctor Name: | MARK DOUGLAS MCENTIRE |
| NPI Number: | 1073626610 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 006893 |
| Business Practice Address: | 6499 Mason-montgomery Road Suite D Mason, OH - 45040 |
| Business Phone Number: | 5133367642 |
| Business Fax Number: | |
| Mailing Address: | 8182 Autumn Place, MASON |
| State: | OH |
| Postal Code: | 45040 |
| Phone Number: | 5137540390 |
| Fax Number: | |
| NPI Enumeration Date: | 08/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 006893 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |