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1144951369
JONATHAN LUCERO MCKINNEY
PROVIDENCE, RI
NPI
1144951369
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: RI PA01489)
Enumeration Date
2022-06-20
Last Update Date
2024-03-26
Business Address
JONATHAN LUCERO MCKINNEY PA-C
825 CHALKSTONE AVE
PROVIDENCE, RI 02908-4728
Phone number: 401-456-2000
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Mailing Address
JONATHAN LUCERO MCKINNEY PA-C
40 PRINCETON AVE
PROVIDENCE, RI 02907-4115
Phone number: 717-673-7066
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