Individual
MR. EDWARD GOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, MLD
Contact information
Practice address
148 WATERMAN ST, PROVIDENCE, RI 02906-2130
(401) 861-1070
Mailing address
30 TECUMSEH ST., APT, SUITE, BLDG. (OPTIONAL), PROVIDENCE, RI 02906
(401) 861-1070
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT01564
RI
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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