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1447981592
SPIRO ODYSSEAS KOUSTAS
PROVIDENCE, RI
NPI
1447981592
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: RI CLP05675)
Enumeration Date
2022-06-20
Last Update Date
2022-06-20
Business Address
SPIRO ODYSSEAS KOUSTAS MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-5180
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Mailing Address
SPIRO ODYSSEAS KOUSTAS MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number:
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