Provider Demographics
NPI:1336316132
Name:ATWOOD ORTHOPEDIC ASSOC
Entity Type:Organization
Organization Name:ATWOOD ORTHOPEDIC ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-331-1113
Mailing Address - Street 1:PO BOX 19427
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-331-1113
Mailing Address - Fax:401-331-1153
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919
Practice Address - Country:US
Practice Address - Phone:401-331-1113
Practice Address - Fax:401-331-1153
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREDERICK M JOHNSON MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT00312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty