Individual
ANDRE JOSEPH THIBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
285 PROMENADE ST, PROVIDENCE, RI 02908
(401) 459-4008
(401) 459-4010
Mailing address
285 PROMENADE ST, PROVIDENCE, RI 02908-5794
(401) 459-4008
(401) 459-4010
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT02399
RI
Other
Enumeration date
07/11/2011
Last updated
07/19/2011
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