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General NPI Number Information
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NPI Number | 1982909073
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Entity Type | Organization
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Legal Business Name | TOLL GATE CHIROPRACTIC LTD
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 189 TOLL GATE RD
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City | WARWICK
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State | RI
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Zip | 02886-4445
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Country | US
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Telephone | 401-738-8154
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Fax | 401-732-1301
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Provider Business Mailing Address
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Address Line | 189 TOLL GATE RD
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City | WARWICK
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State | RI
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Zip | 02886-4445
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Country | US
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Telephone | 401-738-8154
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Fax | 401-732-1301
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. AMANDA MEDEIROS
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Credential |
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Telephone | 401-738-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 258
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License Number State | RI
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