Provider Demographics
NPI:1952867707
Name:SAUCIER, THOMAS J (LMT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:SAUCIER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 E MAIN RD SUITE 5A
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5288
Mailing Address - Country:US
Mailing Address - Phone:401-419-7995
Mailing Address - Fax:
Practice Address - Street 1:575 E MAIN RD SUITE 5A
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5288
Practice Address - Country:US
Practice Address - Phone:401-419-7995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMT00875225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist