=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245226844
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RHODE ISLAND THERAPY SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2005
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 TOWER HILL RD
-----------------------------------------------------
City | NORTH KINGSTOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02852-4814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-295-8500
-----------------------------------------------------
Fax | 401-295-8536
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 TOWER HILL RD
-----------------------------------------------------
City | WICKFORD
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02852-4814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-295-8500
-----------------------------------------------------
Fax | 401-295-8536
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. MICHAEL S NOONAN
-----------------------------------------------------
Credential | MS. PT.
-----------------------------------------------------
Telephone | 401-295-8500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------