Individual
JOHNATHAN MATTHEW ANDERSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 S COUNTY TRL, EAST GREENWICH, RI 02818-1536
(401) 295-2955
Mailing address
3595 POST RD APT 23205, WARWICK, RI 02886-7030
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA01335
RI
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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