Organization
LIFESTYLE MEDICINE OF RHODE ISLAND, LLC
Active
Other names
RI Weightloss, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA MARY FONTAINE (PRACTICE MANAGER)
(401) 228-6844
Entity
Organization
Contact information
Practice address
1524 ATWOOD AVE STE 336, JOHNSTON, RI 02919-3228
(401) 228-6844
(401) 228-6855
Mailing address
1524 ATWOOD AVE STE 336, JOHNSTON, RI 02919-3228
(401) 228-6844
(401) 228-6855
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD04110
RI
207QB0002X
Obesity Medicine (Family Medicine) Physician
MD04110
RI
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
MD04110
RI
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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