Individual
JENNA GRAVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 MARTIN ST, CUMBERLAND, RI 02864-5321
(401) 228-2186
Mailing address
21 DRAKE DR, RICHMOND, RI 02892-1189
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT03063
RI
Other
Enumeration date
11/06/2017
Last updated
12/23/2021
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