Provider Demographics
NPI:1073849097
Name:CLARE, JOSHUA RONALD (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RONALD
Last Name:CLARE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 AQUIDNECK AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5255
Mailing Address - Country:US
Mailing Address - Phone:401-845-0840
Mailing Address - Fax:401-845-0842
Practice Address - Street 1:1181 AQUIDNECK AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842
Practice Address - Country:US
Practice Address - Phone:401-845-0840
Practice Address - Fax:401-845-0842
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist