Healthcare Provider Details

I. General information

NPI: 1033380266
Provider Name (Legal Business Name): SILK PHYSICAL THERAPY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2008
Last Update Date: 03/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 GANO ST
PROVIDENCE RI
02906-3808
US

IV. Provider business mailing address

167 GANO ST
PROVIDENCE RI
02906-3808
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-4325
  • Fax: 401-274-0329
Mailing address:
  • Phone: 401-274-4325
  • Fax: 401-274-0329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT00426
License Number StateRI

VIII. Authorized Official

Name: MR. ALAN NEIL SILK
Title or Position: PRESIDENT
Credential: PT
Phone: 401-274-4325