Individual
MICHAEL WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1974 BROAD ST # 2, CRANSTON, RI 02905-3429
(603) 803-2121
Mailing address
1974 BROAD ST # 2, CRANSTON, RI 02905-3429
(603) 803-2121
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3551
MA
Other
Enumeration date
04/17/2019
Last updated
06/28/2021
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