Individual
KYLE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
135 DODGE ST, PROVIDENCE, RI 02907-2210
(401) 383-5150
Mailing address
135 DODGE ST, PROVIDENCE, RI 02907-2210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN51820
RI
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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