Individual
ALLEN JEREMIAH FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 WAMPANOAG TRL, RIVERSIDE, RI 02915-2218
(860) 455-8411
Mailing address
38 ASH ST, MANVILLE, RI 02838-1520
(860) 455-8411
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT02300
RI
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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