Individual
GENNADIY KRICHEVSKIY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
251 WATERMAN ST, PROVIDENCE, RI 02906-5210
(401) 453-4263
Mailing address
251 WATERMAN ST, PROVIDENCE, RI 02906-5210
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
00730
RI
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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