Individual
MR. CORY CHARLES VIVEIROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 OLD FERRY RD, BRISTOL, RI 02809-2921
(410) 254-3319
Mailing address
1 OLD FERRY RD, BRISTOL, RI 02809-2921
(410) 254-3319
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000006868
RI
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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