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Organization
MIND AND BODY REHAB LLC
Active
Organization
MIND AND BODY REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY ANDRADE (OWNER)
40172213111
Entity
Organization
Contact information
Practice address
461 MAIN ST, PAWTUCKET, RI 02860-2913
(401) 722-1311
(401) 722-2246
Mailing address
461 MAIN ST, PAWTUCKET, RI 02860-2913
(401) 722-1311
(401) 722-2246
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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