Provider Demographics
NPI:1467558825
Name:SAUVE, JARED P (MPT)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:P
Last Name:SAUVE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DUDLEY ST
Mailing Address - Street 2:STE 200
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3236
Mailing Address - Country:US
Mailing Address - Phone:401-457-1162
Mailing Address - Fax:401-847-9136
Practice Address - Street 1:19 FRIENDSHIP ST
Practice Address - Street 2:STE 310
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2200
Practice Address - Country:US
Practice Address - Phone:401-457-1162
Practice Address - Fax:401-847-9136
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA16094225100000X
RIPT022952251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist