| NPI | 1104507169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS TANNER Doctor Of Physical Therapy 401-688-6431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-08-08 |