Most Relevant Information
Provider Data
| NPI Number: | 1003453184 |
| Provider Name: | BRIANNA SOUTHWICK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA01397 |
Most Important Dates
| Enumeration Date: | 12/07/2019 |
| Last Updated: | 12/29/2021 |
Provider Practice Location
333 BUDLONG RD
CRANSTON
RI
029206337
Practice Location Phone/Fax
| Phone: | 4019434530 |
| Fax: |
Provider Mailing Location
333 BUDLONG RD
CRANSTON
RI
029206337
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |