| NPI | 1720482193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KEVIN DOMENICO Owner 401-725-5576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: RI DPM00327) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2017-04-24 |