Individual
AUDREY WOSTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
373 HILLSDALE RD, WEST KINGSTON, RI 02892-1007
(401) 932-7787
Mailing address
373 HILLSDALE RD, WEST KINGSTON, RI 02892-1007
(401) 932-7787
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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