Individual
ERIC BOETTJER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 921-9212
Mailing address
455 TOLL GATE RD, PRC AND CREDENTIALING, WARWICK, RI 02886-2759
(401) 273-0641
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00889
RI
363A00000X
Physician Assistant
PA7762
MA
Other
Enumeration date
08/12/2016
Last updated
07/10/2024
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