| Organization Name: | RONALD S MASH PA |
| NPI Number: | 1104952589 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD MASH (PRES) |
| Mailing Address: | 1240 3rd Ave E Suite 9 Shakopee |
| State: | MN US |
| Postal Code: | 553791679 |
| Phone Number: | 9524457890 |
| Fax Number: | 9524457893 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 12/03/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |