Individual
KEVIN COLASURDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 IRONS AVE, JOHNSTON, RI 02919-2707
(413) 636-5048
Mailing address
21 IRONS AVE, JOHNSTON, RI 02919-2707
(413) 636-5048
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT00414
RI
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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