Organization
ELMWOOD ORTHOPEDIC REHAB CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR YATSKAR M.S., P.T. (PRESIDENT)
(617) 442-3462
Entity
Organization
Contact information
Practice address
120 DUDLEY ST STE 201, PROVIDENCE, RI 02905-2431
(401) 941-1347
(617) 445-7874
Mailing address
193 ELMWOOD AVE, PROVIDENCE, RI 02907-1460
(401) 459-4000
(401) 459-4005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01849
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E061618
—
RI
Enumeration date
02/22/2007
Last updated
01/26/2022
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