Individual
KELLY ANNE TEIXEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
285 PROMENADE ST, PROVIDENCE, RI 02908-5719
(401) 459-4008
(401) 459-4010
Mailing address
285 PROMENADE ST, PROVIDENCE, RI 02908-5719
(401) 459-4008
(401) 459-4010
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT00242
RI
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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