# WHOLE HEALTH PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124134895
- **Authorized official:** AMANDA J PELOQUIN (ACCOUNT MANAGER)
- **Authorized official phone:** (401) 722-2225

## Contact information

- **Practice address:** 409 EAST AVE, SUITE 110, PAWTUCKET, RI 02860-5265
- **Practice address phone:** (401) 722-2225
- **Practice address fax:** (401) 722-2235
- **Mailing address:** 409 EAST AVE, SUITE 110, PAWTUCKET, RI 02860-5265
- **Mailing address phone:** (401) 722-2225
- **Mailing address fax:** (401) 722-2235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT00502 | RI | Yes |

## Other

- **Enumeration date:** 08/22/2006
- **Last updated:** 01/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 06400314 | UNITED HEALTHCARE | RI |
| 01 | — | 4259 | NEIGHBORHOOD HELATH PLAN | RI |