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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