Individual
JOANN AYUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 PEMBERTON ST, PROVIDENCE, RI 02908-4426
(508) 494-0724
Mailing address
4 PEMBERTON ST, PROVIDENCE, RI 02908-4426
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2092199
TX
225200000X
Physical Therapy Assistant
PTA00754
RI
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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