Individual
MR. JASON THOMAS LEGERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8661
Mailing address
20 WOODLAND RD, WRENTHAM, MA 02093-1308
(508) 384-0121
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT02075
RI
225100000X
Physical Therapist
PT11181
MA
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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