Provider Demographics
NPI:1154420297
Name:POIRIER, NICOLE D (PT)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:D
Last Name:POIRIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 GRANITE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5350
Mailing Address - Country:US
Mailing Address - Phone:819-613-3707
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:23 KEEWAYDIN DR STE 101
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2857
Practice Address - Country:US
Practice Address - Phone:603-912-7148
Practice Address - Fax:603-912-7149
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17687225100000X
NH3413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist