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Individual

DEREK LOUPIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
12 STILLWATER AVE, BANGOR, ME 04401-3984
(207) 945-2946
Mailing address
31 EARLE AVE # 2, BANGOR, ME 04401-3462
(207) 947-4211

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT2667
LICENSE#
ME
Enumeration date
11/03/2006
Last updated
07/08/2007
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