Individual
GERALD R ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
24 SALT POND RD, H-5, WAKEFIELD, RI 02879-4314
(401) 792-8500
(401) 792-8877
Mailing address
300 TOWER HILL RD, UNIT 128, NORTH KINGSTOWN, RI 02852-4814
(401) 295-8500
(401) 295-8536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1622
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
408399
BLUECHIP
—
Enumeration date
02/22/2006
Last updated
04/05/2016
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