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Organization

RI PLASTIC SURGERY OPERATORY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KATHLEEN GLASSIE (MANAGER)
(401) 855-0605
Entity
Organization

Contact information

Practice address
10 BRIDGE ST, PROVIDENCE, RI 02903-4362
(401) 453-0120
(401) 453-0198
Mailing address
10 BRIDGE STREET, PROVIDENCE, RI 02903
(401) 453-0120
(401) 453-0198

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000000
RI

Other

Enumeration date
11/21/2012
Last updated
11/21/2012
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