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General NPI Number Information
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NPI Number | 1134658966
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Entity Type | Organization
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Legal Business Name | RHODE ISLAND POST ACUTE MEDICAL SERVICES 1 PC
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 161 POST RD
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City | WESTERLY
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State | RI
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Zip | 02891-2673
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Country | US
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Telephone | 865-693-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 265 BROOKVIEW CENTRE WAY STE 400
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City | KNOXVILLE
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State | TN
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Zip | 37919-4052
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Country | US
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Telephone | 865-693-1000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID ISTVAN HOLTZCLAW
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Credential | MD
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Telephone | 954-584-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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