Healthcare Provider Details

I. General information

NPI: 1871766691
Provider Name (Legal Business Name): CONTROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2008
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 POST RD STE 116
EAST GREENWICH RI
02818-3400
US

IV. Provider business mailing address

100 HARTSHORN RD
PROVIDENCE RI
02906-5003
US

V. Phone/Fax

Practice location:
  • Phone: 401-885-0069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWRENCE GEORGE WEISMAN
Title or Position: MEMBER/OWNER
Credential:
Phone: 401-885-0069