Healthcare Provider Details

I. General information

NPI: 1265378681
Provider Name (Legal Business Name): PROCARE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

588 PAWTUCKET AVE
PAWTUCKET RI
02860-6057
US

IV. Provider business mailing address

3 BENEFIT ST
WESTERLY RI
02891-2312
US

V. Phone/Fax

Practice location:
  • Phone: 401-282-8052
  • Fax:
Mailing address:
  • Phone: 401-282-8052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA M SHELTON
Title or Position: PHYSICAL THERAPIST ASSISTANT
Credential:
Phone: 401-282-8052