Individual
JACQUELINE SIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
455 DOUGLAS AVE, PROVIDENCE, RI 02908-2542
(401) 553-8600
Mailing address
455 DOUGLAS AVE, PROVIDENCE, RI 02908-2542
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15149
MA
225100000X
Physical Therapist
Primary
PT01541
RI
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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