# PROVIDENT PAIN AND WELLNESS CLINIC

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

## Provider details

- **NPI number:** 1639404635
- **Authorized official:** RAUL A MASING MD (OWNER)
- **Authorized official phone:** (401) 499-7771

## Contact information

- **Practice address:** 19 FRIENDSHIP ST, SUITE 160, NEWPORT, RI 02840-2200
- **Practice address phone:** (401) 499-7771
- **Mailing address:** 75 NEWMAN AVE, SUITE 100, RUMFORD, RI 02916-3603
- **Mailing address phone:** (401) 453-0666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 10503 | RI | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 10503 | RI | Yes |
| 225100000X | Physical Therapist | PT01902 | RI | — |

## Other

- **Enumeration date:** 10/08/2009
- **Last updated:** 03/28/2011