Individual
JASON LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
111 BREWSTER ST, FCC-C, PAWTUCKET, RI 02860-4474
(401) 729-2769
Mailing address
111 BREWSTER ST, FCC-C, PAWTUCKET, RI 02860-4474
(401) 729-2769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LP03490
RI
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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