JAKE T BROCCOLO

NORTH PROVIDENCE, RI
NPI1144709114
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: RI  PT03093)
Enumeration Date2018-08-10
Last Update Date2023-11-03
Business Address
JAKE T BROCCOLO DPT
1401 DOUGLAS AVE
NORTH PROVIDENCE, RI 02904-4058
Phone number: 401-726-7100
Mailing Address
JAKE T BROCCOLO DPT
4 RICHMOND SQ STE 200
PROVIDENCE, RI 02906-5117
Phone number: 401-433-4172
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