Organization
HOPE CHIROPRACTIC CENTRE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL DAVID BROCCOLI D.C. (PRESIDENT)
(401) 351-6390
Entity
Organization
Contact information
Practice address
635 HOPE ST, PROVIDENCE, RI 02906-2652
(401) 351-6390
(401) 331-0614
Mailing address
635 HOPE ST, PROVIDENCE, RI 02906-2652
(401) 351-6390
(401) 331-0614
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DCP00204
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689740607
INDIVIDUAL NPI NUMBER
RI
01
—
9047-6
BLUE CROSS BLUE SHIELD RI
RI
Enumeration date
02/26/2007
Last updated
10/16/2008
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