Individual
JUSTIN SIMAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
139 BENEFIT ST, PAWTUCKET, RI 02861-1024
(401) 423-4433
Mailing address
222 JEFFERSON BLVD STE 4, WARWICK, RI 02888-3847
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710001422
—
RI
Enumeration date
06/02/2023
Last updated
06/02/2023
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