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General NPI Number Information
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NPI Number | 1194873331
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Entity Type | Individual
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Provider Name | JOANNE MARY POOLE PT
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Gender | Female
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5908 E 1050 S
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City | LYNN
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State | IN
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Zip | 47355-8914
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Country | US
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Telephone | 765-277-0472
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Fax | 765-874-1784
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Provider Business Mailing Address
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Address Line | 5908 E 1050 S
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City | LYNN
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State | IN
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Zip | 47355-8914
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Country | US
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Telephone | 765-277-0472
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Fax | 765-874-1784
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05005197A
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License Number State | IN
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