Healthcare Provider Details

I. General information

NPI: 1407767999
Provider Name (Legal Business Name): ZACHARIAH MONNIN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 MICHIGAN ST
SIDNEY OH
45365-2401
US

IV. Provider business mailing address

955 FOX TAIL
RUSSIA OH
45363-9815
US

V. Phone/Fax

Practice location:
  • Phone: 937-498-5332
  • Fax:
Mailing address:
  • Phone: 937-467-9537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.012146
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: