Individual
CHIMENG JUSTIN THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
588 PAWTUCKET AVE, PAWTUCKET, RI 02860-6057
(401) 728-6500
Mailing address
20 MARBLEHEAD AVE, NORTH PROVIDENCE, RI 02904-4267
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA01448
RI
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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