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Organization
POULIN PERFORMANCE, INC.
Active
Organization
POULIN PERFORMANCE, INC.
Active
Other names
Poulin Performance and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA AUDETTE CRITCHLOW CAPPM (PRACTICE ADMINISTRATOR)
(802) 656-0949
Entity
Organization
Contact information
Practice address
21 GREGORY DR, SUITE 120, SOUTH BURLINGTON, VT 05403-6080
(802) 658-0949
(802) 658-1436
Mailing address
PO BOX 486, WILLISTON, VT 05495-0486
(802) 658-0949
(802) 658-1436
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0002746
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0632746
CIGNA
UT
05
—
1009260
—
VT
01
—
59089
BCBS
VT
Enumeration date
07/04/2006
Last updated
10/23/2008
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