Organization
BLACKSTONE VALLEY FOOT AND ANKLE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH KEVIN DOMENICO DPM (OWNER)
(401) 725-5576
Entity
Organization
Contact information
Practice address
345 ARMISTICE BLVD, PAWTUCKET, RI 02861-2429
(401) 725-5576
(401) 725-2640
Mailing address
345 ARMISTICE BLVD, PAWTUCKET, RI 02861-2429
(401) 725-5576
(401) 725-2640
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPM00327
RI
Other
Enumeration date
10/14/2014
Last updated
04/24/2017
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