Individual
NICHOLAS BOISSONEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1365 BROADWAY, BANGOR, ME 04401-2401
(207) 942-2233
Mailing address
138 DARTMOUTH ST, BANGOR, ME 04401-4126
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT26565
FL
225100000X
Physical Therapist
PT4197
ME
Other
Enumeration date
07/01/2011
Last updated
06/09/2015
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