| NPI | 1811340631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH RODGERS Member 401-275-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: RI MD10279) |
| Enumeration Date | 2016-07-16 |
| Last Update Date | 2016-07-16 |