Individual
MARK LIBASSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1395 ATWOOD AVE STE 103, JOHNSTON, RI 02919-4930
(401) 943-4330
(401) 943-4331
Mailing address
1450 ATWOOD AVENUE, JOHNSTON, RI 02919-4840
(401) 943-4330
(401) 943-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
113
RI
Other
Enumeration date
08/23/2011
Last updated
04/08/2019
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