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Organization

WHOLE HEALTH PHYSICAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA J PELOQUIN (ACCOUNT MANAGER)
(401) 722-2225
Entity
Organization

Contact information

Practice address
409 EAST AVE, SUITE 110, PAWTUCKET, RI 02860-5265
(401) 722-2225
(401) 722-2235
Mailing address
409 EAST AVE, SUITE 110, PAWTUCKET, RI 02860-5265
(401) 722-2225
(401) 722-2235

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00502
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06400314
UNITED HEALTHCARE
RI
01
4259
NEIGHBORHOOD HELATH PLAN
RI
Enumeration date
08/22/2006
Last updated
01/22/2008
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