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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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