Healthcare Provider Details

I. General information

NPI: 1851862692
Provider Name (Legal Business Name): PAPPAS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1539 ATWOOD AVE STE 202
JOHNSTON RI
02919-3262
US

IV. Provider business mailing address

PO BOX 20372
CRANSTON RI
02920-0944
US

V. Phone/Fax

Practice location:
  • Phone: 401-351-0515
  • Fax: 401-351-0530
Mailing address:
  • Phone: 401-351-0515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J PAPPAS
Title or Position: CEO/OWNER
Credential: DPT
Phone: 401-351-0515