Individual
MRS. KIM MICHAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFO
Contact information
Practice address
1 VA CTR, PROSTHETIC SERVICE (126P), AUGUSTA, ME 04330-6719
(207) 623-5769
(207) 623-5779
Mailing address
106 OAK GROVE RD, VASSALBORO, ME 04989-3230
(207) 873-1756
(207) 623-5779
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CFO01953
ABC CERFITICATION
—
Enumeration date
08/21/2006
Last updated
07/08/2007
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