Individual
MATTHEW SHANE DONNELLY ST GERMAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, LMT
Contact information
Practice address
422 POST RD, SUITE G2, WARWICK, RI 02888-2802
(401) 467-9193
Mailing address
144 WATERMAN ST STE 5, PROVIDENCE, RI 02906-2126
(401) 413-7525
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
705
RI
Other
Enumeration date
01/13/2012
Last updated
11/07/2023
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