Healthcare Provider Details

I. General information

NPI: 1457370496
Provider Name (Legal Business Name): PAUL E SAYOUR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 TEN ROD RD
NORTH KINGSTOWN RI
02852-4206
US

IV. Provider business mailing address

610 TEN ROD ROAD
NORTH KINGSTON RI
02852
US

V. Phone/Fax

Practice location:
  • Phone: 401-295-9767
  • Fax: 401-295-0230
Mailing address:
  • Phone: 401-295-9767
  • Fax: 401-295-0230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDCP00345
License Number StateRI

VIII. Authorized Official

Name: PAUL E SAYOUR
Title or Position: OWNER PROVIDER
Credential: DC
Phone: 401-295-9767