Provider Demographics
NPI:1437228228
Name:RHODE ISLAND CHIROPRACTIC PAIN CONTROL CLINIC, INC.
Entity Type:Organization
Organization Name:RHODE ISLAND CHIROPRACTIC PAIN CONTROL CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:LANCELLOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-274-9355
Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE 210A
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-274-9355
Mailing Address - Fax:401-455-0290
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 210A
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-274-9355
Practice Address - Fax:401-455-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty