| Doctor Name: | SHANAN T BRISSETTE |
| NPI Number: | 1093925331 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT02244 |
| Business Practice Address: | 927 Warren Ave East Providence, RI - 029141423 |
| Business Phone Number: | 4014380905 |
| Business Fax Number: | 4013837946 |
| Mailing Address: | 927b Warren Ave, EAST PROVIDENCE |
| State: | RI |
| Postal Code: | 02914 |
| Phone Number: | 4014380905 |
| Fax Number: | 4013837946 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 01/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT02244 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | RI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |