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Organization
BLACKSTONE VALLEY FOOT AND ANKLE INC.
Active
Organization
BLACKSTONE VALLEY FOOT AND ANKLE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH KEVIN DOMENICO DPM (OWNER)
(401) 725-5576
Entity
Organization
Contact information
Practice address
345 ARMISTICE BLVD, PAWTUCKET, RI 02861-2429
(401) 725-5576
(401) 725-2640
Mailing address
345 ARMISTICE BLVD, PAWTUCKET, RI 02861-2429
(401) 725-5576
(401) 725-2640
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPM00327
RI
Other
Enumeration date
10/14/2014
Last updated
04/24/2017
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