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Individual

WILLIAM HENRY WYNNE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
610 WATERMAN AVENUE, EAST PROVIDENCE, RI 02914
(401) 574-0833
(401) 213-6388
Mailing address
610 WATERMAN AVENUE, EAST PROVIDENCE, RI 02914
(401) 574-0833
(401) 213-6388

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00587
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26804
BCBS
RI
01
403815
BCHIP
RI
01
6400236
UHP
Enumeration date
05/03/2006
Last updated
07/08/2007
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