Provider Demographics
NPI:1750400263
Name:PERRY, JOANN (MS PT)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
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Mailing Address - Street 1:129 LINDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:N KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5712
Mailing Address - Country:US
Mailing Address - Phone:401-447-7020
Mailing Address - Fax:
Practice Address - Street 1:1351 S COUNTY TRL
Practice Address - Street 2:BLDG 3 SUITE 305
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5105
Practice Address - Country:US
Practice Address - Phone:401-453-5152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT00985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6400472OtherUNITED
RI240600OtherBLUE CROSS
RI240600OtherBLUE CROSS