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Individual

MR. TIMM K DUMOULIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
103 S MAIN ST, WEST LEBANON, NH 03784-1618
(603) 298-5595
(603) 298-5205
Mailing address
2067 JERICHO ST, WHITE RIVER JUNCTION, VT 05001-9324
(802) 295-3205

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0328
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0806546Y0NH01
BLUE CROSS/BLUE SHIELD
NH
05
40652187
NH
01
9150551
CIGNA
NH
01
DUMO6371
BLUE CROSS VERMONT
VT
Enumeration date
07/01/2006
Last updated
05/18/2016
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