Individual
AUTUMN LYNN POULIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37 POND ST, BANGOR, ME 04401-4641
(207) 945-4334
Mailing address
20 NYES CORNER DR, FAIRFIELD, ME 04937-3414
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PA4831
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/29/2017
Last updated
03/17/2018
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