Organization
RHODE ISLAND INTEGRATED MEDICINE
Active
Other names
RI Integrated Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR M PEDRO DC (DIRECTOR)
(401) 781-3374
Entity
Organization
Contact information
Practice address
521 PARK AVE, CRANSTON, RI 02910-2346
(401) 781-3374
(401) 781-3376
Mailing address
521 PARK AVE, CRANSTON, RI 02910
(401) 781-3374
(401) 781-3376
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
Primary
OT0018
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31492
BLUE CROSS PROV NUMBER
RI
01
—
413445
BLUE CHIP PROV NUMBER
RI
01
—
OT00018
RI STATE LICENCE
RI
Enumeration date
07/24/2006
Last updated
07/23/2008
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