Silver Fern Practice, LLC

NPI #1003972084 in Pawtucket, Rhode Island

Provider Information

NPI Number: 1003972084
Entity Type: Organization
Organization Name: Silver Fern Practice, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SILVER FERN PRACTICE, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Dec 28, 2006
Last Updated: Nov 6, 2025

Practice Location

Address: 545 PAWTUCKET AVE
Address 2: MAILBOX 402
City: Pawtucket
State: Rhode Island
ZIP Code: 02860-6046
Phone: (401) 475-5775

Authorized Official

Name: MICHELLE MONIZ
Title: CREDENTIALING SPECIALIST
Phone: (401) 433-4172

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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