| NPI | 1407010812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LEE MEDEIROS Billing Manager 401-295-2527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: RI 00309) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-07-15 |