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General NPI Number Information
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NPI Number | 1851668453
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Entity Type | Individual
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Provider Name | ALAN LOISELLE PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 11/27/2011
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Last Update Date | 11/27/2011
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Provider Practice Location Address
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Address Line | 300 TOWER HILL RD
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4814
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Country | US
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Telephone | 401-295-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 117 11TH ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-2911
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Country | US
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Telephone | 401-578-9983
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Fax |
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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 | 0322
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License Number State | RI
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