Michael Wadsworth
Specialist/Technologist, Athletic Trainer in Cranston, RI. Individual provider (NPI-1).
NPI number1699338384
StatusActive
Last updated in NPPESJun 28, 2021
Details
- NPI
- 1699338384
- Entity type
- Individual (NPI-1)
- Name
- Michael Wadsworth
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 17, 2019
- Certification date
- Jun 28, 2021
- Last updated
- Jun 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 3551 | MA | Yes |
Practice location
1974 Broad St # 2Cranston, RI 02905-3429
Phone 603-803-2121
Mailing address
1974 Broad St # 2Cranston, RI 02905-3429
Phone 603-803-2121
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