| NPI | 1790649317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARIE MONIZ Credentialing Specialist 401-433-4172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2025-12-10 |
| Last Update Date | 2025-12-10 |