OrganizationActive
Interventional and Functional Pain Center
NPI 1356127773 · Physical Therapy Clinic/Center · Cranston, RI
Provider details
- NPI number
- 1356127773
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Juan Carlos Mirt, Owner(401) 648-6100
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1150 Reservoir Ave Ste 200
Cranston, RI 02920-6043
Phone: (347) 310-0149
Approximate (ZIP-level) locationGet directions
Mailing address
1150 Reservoir Ave Ste 200
Cranston, RI 02920-6043
Registry dates
- Enumerated
- 2023-09-01
- Last updated
- 2023-09-01
- Certified
- 2023-09-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.