Joanne Mary Poole, PT
Individual provider Active NPI Physical Therapist · Lynn, IN
NPI 1194873331 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194873331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 05005197A (IN)
- Practice address
- 5908 E 1050 S
Lynn, IN 47355-8914 - Phone
- (765) 277-0472
- Fax
- (765) 874-1784
- NPI assigned
- Jan 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05005197A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SN Kentuckiana Rehab, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05005197A | IN | Yes |
Addresses
Primary practice location
5908 E 1050 S
Lynn, IN 47355-8914
Mailing address
5908 E 1050 S
Lynn, IN 47355-8914
Phone (765) 277-0472
Other providers in Lynn, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.