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1033286877
KENNETH TETELBAUM
PROVIDENCE, RI
NPI
1033286877
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: RI PTA00356)
Enumeration Date
2006-11-29
Last Update Date
2007-07-08
Business Address
KENNETH TETELBAUM PTA
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-8661
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Mailing Address
KENNETH TETELBAUM PTA
9 CHESTNUT ST
NARRAGANSETT, RI 02882-3903
Phone number: 401-789-9184
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