MEDICARE: MS. ANN MARIE BISSONNETTE PT OCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1447323845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN MARIE BISSONNETTE PT OCS

Provider Business Mailing Address
First Line	:	328 COWESETT AVE
Second Line	:	SUITE 6
City	:	WEST WARWICK
State	:	RI
Zip	:	02893-2248
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	328 COWESETT AVE
Second Line	:	SUITE 6
City	:	WEST WARWICK
State	:	RI
Zip	:	02893-2248
Country	:	US
Telephone Number	:	401-823-8856
Fax Number	:	401-826-8234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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