Individual
SHANAN T BRISSETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
927 WARREN AVE, EAST PROVIDENCE, RI 02914-1423
(401) 438-0905
(401) 383-7946
Mailing address
927B WARREN AVE, EAST PROVIDENCE, RI 02914
(401) 438-0905
(401) 383-7946
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17749
MA
225100000X
Physical Therapist
PT02244
RI
Other
Enumeration date
05/23/2007
Last updated
01/06/2011
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