Individual
WALTER R. VANDYCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
SPRINGFIELD MIDDLE SCHOOL, PROVIDENE SCHOOL DEPARTMENT, 152 SPRINGFIELD ST, PROVIDENCE, RI 02909
(401) 278-0557
Mailing address
10 CANONCHET ST, PROVIDENCE, RI 02908-3802
(401) 751-0109
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
80
RI
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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