Provider Demographics
NPI:1831234590
Name:KING, JOSHUA NEIL (ATC)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:NEIL
Last Name:KING
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 AQUIDNECK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5253
Mailing Address - Country:US
Mailing Address - Phone:401-849-7907
Mailing Address - Fax:
Practice Address - Street 1:1 OLD FERRY RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-2923
Practice Address - Country:US
Practice Address - Phone:401-849-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAT001312081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine