Provider Demographics
NPI:1023213352
Name:DEVINE, JAMES EDWARD (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:DEVINE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 FOX RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:RI
Mailing Address - Zip Code:02898-1160
Mailing Address - Country:US
Mailing Address - Phone:401-539-7381
Mailing Address - Fax:
Practice Address - Street 1:10 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-6716
Practice Address - Country:US
Practice Address - Phone:401-826-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT00524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist