Organization
GENESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA LYNN COLLETTE PTA (PHYSICAL THERAPY ASSISTANT)
(401) 722-7900
Entity
Organization
Contact information
Practice address
70 GILL AVE, PAWTUCKET, RI 02861-4315
(401) 722-7900
Mailing address
70 GILL AVE, PAWTUCKET, RI 02861-4315
(401) 722-7900
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA00767
RI
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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