Individual
ALYSSA LYNN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 731-7000
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 731-7000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO00889
RI
390200000X
Student in an Organized Health Care Education/Training Program
LP02736
RI
Other
Enumeration date
06/14/2013
Last updated
08/15/2017
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