MEDICARE: JESSICA CABRAL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT01929	RI

General Provider Information

NPI Number	:	1649365073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CABRAL PT

Provider Business Mailing Address
First Line	:	1754 DIAMOND HILL RD
Second Line	:	APT 2R
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-5537
Country	:	US
Telephone Number	:	401-385-9530
Fax Number	:	401-385-9532

Provider Business Practice Location Address
First Line	:	1754 DIAMOND HILL RD
Second Line	:	APT 2R
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-5537
Country	:	US
Telephone Number	:	401-385-9530
Fax Number	:	401-385-9532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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Directions to “ JESSICA CABRAL PT” Practice Location

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