Individual
MR. ROBERT RAYMOND IACONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
63 BRAMBLE LN, WEST WARWICK, RI 02893-5505
(401) 821-1395
Mailing address
63 BRAMBLE LN, WEST WARWICK, RI 02893-5505
(401) 821-1395
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
RIOTA00628
RI
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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