Provider Demographics
NPI:1760629596
Name:PAPPAS PHYSICAL THERAPY OF WESTERLY, INC
Entity Type:Organization
Organization Name:PAPPAS PHYSICAL THERAPY OF WESTERLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:401-351-0515
Mailing Address - Street 1:PO BOX 20372
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0944
Mailing Address - Country:US
Mailing Address - Phone:401-351-0515
Mailing Address - Fax:401-351-0530
Practice Address - Street 1:77 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-3167
Practice Address - Country:US
Practice Address - Phone:401-351-0515
Practice Address - Fax:401-351-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty