Individual
MR. THOMAS G POULIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
199 CEDAR ST, BANGOR, ME 04401-4638
(207) 944-5501
Mailing address
PO BOX 217, BANGOR, ME 04402-0217
(207) 990-5001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ALLS 1790
ME
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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