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Individual

DR. KATHY ANN BOULET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
675 MAIN ST, SUITE 18, LEWISTON, ME 04240-5802
(207) 782-1171
(207) 782-6176
Mailing address
675 MAIN ST, SUITE 18, LEWISTON, ME 04240-5802
(207) 782-1171
(207) 782-6176

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
005842
MO
111N00000X
Chiropractor
Primary
CR779
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0075
HARVARD PILGRIM HEALTHCAR
ME
01
018172
ANTHEM BLUE CROSS AND BS
ME
01
350052598
RAILROAD MEDICARE
ME
01
4404011
UNITED HEALTHCARE
ME
01
620063501
CIGNA GROUP NO.
ME
01
620070401
CIGNA INDIVIDUAL NO.
ME
01
M23107
CIGNA HMO NO.
ME
Enumeration date
12/06/2006
Last updated
09/13/2013
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