Provider Demographics
NPI:1891962924
Name:POOLE, ALLISON RENA LAMARRE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:RENA LAMARRE
Last Name:POOLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:RENA
Other - Last Name:LAMARRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:619 BRIGHTON AVE # 101
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2323
Mailing Address - Country:US
Mailing Address - Phone:207-358-8161
Mailing Address - Fax:207-352-5111
Practice Address - Street 1:619 BRIGHTON AVE # 101
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2323
Practice Address - Country:US
Practice Address - Phone:207-358-8161
Practice Address - Fax:207-352-5111
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3294225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist