Individual
KISHAN THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 793-2695
(401) 444-4165
Mailing address
970 N SPOEDE RD UNIT 45, SAINT LOUIS, MO 63146-5565
(314) 757-9857
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
06/02/2024
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