Individual
MR. ROY KENJI OMORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
372 BROADWAY, NEWPORT, RI 02840-1777
(401) 864-1258
Mailing address
25 ANNANDALE RD, NEWPORT, RI 02840-3601
(401) 864-1258
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
01025
RI
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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