Provider Demographics
NPI:1063435105
Name:MUTSCHINK, MARK DAVID (PT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:DAVID
Last Name:MUTSCHINK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3875 E SOUTHCROSS BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222
Mailing Address - Country:US
Mailing Address - Phone:512-769-9207
Mailing Address - Fax:
Practice Address - Street 1:3875 E SOUTHCROSS, STE B
Practice Address - Street 2:RYKE PHYSICAL THERAPY & SPORTS MEDICINE
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222
Practice Address - Country:US
Practice Address - Phone:210-337-7953
Practice Address - Fax:210-337-7966
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1140291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist