Individual
DR. PHILLIP T WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1109 ATWELLS AVE, PROVIDENCE, RI 02909-4144
(401) 569-9488
Mailing address
1109 ATWELLS AVE, PROVIDENCE, RI 02909-4144
(401) 569-9488
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2915
MA
111N00000X
Chiropractor
Primary
DCP00500
RI
111N00000X
Chiropractor
X010778-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31387
BCBSRI
RI
01
—
412382
BLUE CHIP
RI
01
—
670397
UNITEDHEALTHCARE
RI
Enumeration date
07/17/2006
Last updated
05/18/2015
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