JACK R BEVIVINO

PROVIDENCE, RI
NPI1780705707
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208200000X Plastic Surgery
(Licence: RI  RIMD05259)
Enumeration Date2007-04-03
Last Update Date2007-07-08
Business Address
-- JACK R BEVIVINO MD
120 DUDLEY STREET SUITE #201
PROVIDENCE, RI 02905-2431
Phone number: 401-521-9290
Mailing Address
-- JACK R BEVIVINO MD
120 DUDLEY STREET SUITE #201
PROVIDENCE, RI 02905-2431
Phone number: 401-521-9290
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