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Individual

THEADORE PERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
251 INDIANA AVE, PROVIDENCE, RI 02905-2822
(401) 489-9977
Mailing address
251 INDIANA AVE, PROVIDENCE, RI 02905-2822
(401) 489-9977

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
06/01/2017
Last updated
06/01/2017
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