Provider Demographics
NPI:1689835969
Name:ABBOTT VALLEY VETERINARY CENTER
Entity Type:Organization
Organization Name:ABBOTT VALLEY VETERINARY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:401-334-2765
Mailing Address - Street 1:4232 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1508
Mailing Address - Country:US
Mailing Address - Phone:401-334-2765
Mailing Address - Fax:
Practice Address - Street 1:4232 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-1508
Practice Address - Country:US
Practice Address - Phone:401-334-2765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00420174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty