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Organization
PROVIDENT PAIN AND WELLNESS CLINIC
Active
Organization
PROVIDENT PAIN AND WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL A MASING MD (OWNER)
(401) 499-7771
Entity
Organization
Contact information
Practice address
19 FRIENDSHIP ST, SUITE 160, NEWPORT, RI 02840-2200
(401) 499-7771
Mailing address
75 NEWMAN AVE, SUITE 100, RUMFORD, RI 02916-3603
(401) 453-0666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
10503
RI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
10503
RI
225100000X
Physical Therapist
PT01902
RI
Other
Enumeration date
10/08/2009
Last updated
03/28/2011
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