Individual
EVAN MCMANAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
433 BROADWAY, PROVIDENCE, RI 02909-1624
(401) 680-0334
Mailing address
433 BROADWAY, PROVIDENCE, RI 02909-1624
(401) 680-0334
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW02741
RI
225700000X
Massage Therapist
MA60845227
WA
225700000X
Massage Therapist
MT02510
RI
Other
Enumeration date
03/27/2018
Last updated
08/26/2022
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