Individual
MARIO D. SANTOMASSIMO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
51 SOCKANOSSET CROSS RD, CRANSTON, RI 02920-5536
(401) 944-7574
(401) 944-7602
Mailing address
51 SOCKANOSSET CROSS RD, CRANSTON, RI 02920-5536
(401) 944-7574
(401) 944-7602
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00783
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT00783
STATE LICENSE NUMBER
RI
Enumeration date
02/07/2007
Last updated
08/22/2014
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