Individual
SHANA DEFUSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, CPT
Contact information
Practice address
1193 RESERVOIR AVE, CRANSTON, RI 02920-6008
(401) 228-3939
(401) 383-3043
Mailing address
1193 RESERVOIR AVE, CRANSTON, RI 02920-6008
(401) 228-3939
(401) 383-3043
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA01347
RI
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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