Provider Demographics
NPI:1396004255
Name:POISSON, DANIEL E (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:POISSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3511
Mailing Address - Country:US
Mailing Address - Phone:508-226-2213
Mailing Address - Fax:508-431-2637
Practice Address - Street 1:63 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2219
Practice Address - Country:US
Practice Address - Phone:508-455-0442
Practice Address - Fax:508-455-1432
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist