Provider Demographics
NPI:1578574893
Name:HOULE, MARC A (PT)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:A
Last Name:HOULE
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 1:15 CATAMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-1203
Mailing Address - Country:US
Mailing Address - Phone:401-434-7784
Mailing Address - Fax:
Practice Address - Street 1:1 BLACKSTONE STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-453-7520
Practice Address - Fax:401-453-7529
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist