Provider Demographics
NPI:1326212515
Name:BANDOLA, KARI ELIZABETH (MSPT)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ELIZABETH
Last Name:BANDOLA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3595 POST RD
Mailing Address - Street 2:APARTMENT 8-807
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7078
Mailing Address - Country:US
Mailing Address - Phone:401-742-0401
Mailing Address - Fax:
Practice Address - Street 1:250 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4382
Practice Address - Country:US
Practice Address - Phone:401-384-6490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist