# SPORT & SPINE PHYSICAL THERAPY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** S Corp
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164595609
- **Authorized official:** MRS. COLLEEN S MCGLOIN (PRESIDENT)
- **Authorized official phone:** (401) 823-8856

## Contact information

- **Practice address:** 328 COWESETT AVE, SUITE 6, WEST WARWICK, RI 02893-2248
- **Practice address phone:** (401) 823-8856
- **Practice address fax:** (401) 826-8234
- **Mailing address:** 328 COWESETT AVE, SUITE 6, WEST WARWICK, RI 02893-2248
- **Mailing address phone:** (401) 823-8856
- **Mailing address fax:** (401) 826-8234

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 10/24/2011