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1780705707
JACK R BEVIVINO
PROVIDENCE, RI
NPI
1780705707
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208200000X Plastic Surgery
(Licence: RI RIMD05259)
Enumeration Date
2007-04-03
Last Update Date
2007-07-08
Business Address
-- JACK R BEVIVINO MD
120 DUDLEY STREET SUITE #201
PROVIDENCE, RI 02905-2431
Phone number: 401-521-9290
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Mailing Address
-- JACK R BEVIVINO MD
120 DUDLEY STREET SUITE #201
PROVIDENCE, RI 02905-2431
Phone number: 401-521-9290
Copy
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