Healthcare Provider Details

I. General information

NPI: 1508385345
Provider Name (Legal Business Name): RHODE ISLAND LIMB CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 CEDAR AVE UNIT 12
EAST GREENWICH RI
02818
US

IV. Provider business mailing address

1559 ELMWOOD AVE
CRANSTON RI
02910-3845
US

V. Phone/Fax

Practice location:
  • Phone: 401-884-9541
  • Fax: 401-884-9509
Mailing address:
  • Phone: 401-941-6230
  • Fax: 401-941-6339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN R TEOLI
Title or Position: PRESIDENT
Credential: MSPO, CPO
Phone: 401-941-6230