Healthcare Provider Details

I. General information

NPI: 1447175484
Provider Name (Legal Business Name): EMILY MCGOVERN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 NOOSENECK HILL RD STE 1
WEST GREENWICH RI
02817-1523
US

IV. Provider business mailing address

66 NOOSENECK HILL RD STE 1
WEST GREENWICH RI
02817-1523
US

V. Phone/Fax

Practice location:
  • Phone: 401-397-8399
  • Fax: 401-397-8398
Mailing address:
  • Phone: 401-397-8399
  • Fax: 401-397-8398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT04167
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: