Organization
FORM & FUNCTION PHYSICAL THERAPY AND SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUERRINO BONI (OWNER)
(401) 465-8244
Entity
Organization
Contact information
Practice address
250 SCRABBLETOWN RD, NORTH KINGSTOWN, RI 02852-3016
(617) 326-3008
Mailing address
250 SCRABBLETOWN RD, NORTH KINGSTOWN, RI 02852-3016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT01838
RI
Other
Enumeration date
07/23/2014
Last updated
01/31/2018
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