Individual
BRIANA M LACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
470 TOLL GATE RD STE 203, WARWICK, RI 02886-2741
(401) 751-1235
Mailing address
470 TOLL GATE RD STE 203, WARWICK, RI 02886-2741
(401) 751-1235
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01081
RI
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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