Organization
PARK SQUARE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL NORMAN THIVIERGE (OWNER)
(401) 323-8682
Entity
Organization
Contact information
Practice address
1416 PARK AVE, WOONSOCKET, RI 02895-6557
(401) 323-8682
(401) 765-0123
Mailing address
1416 PARK AVE, WOONSOCKET, RI 02895-6557
(401) 323-8682
(401) 765-0123
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
08/17/2011
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