Individual
MARK HARRISON CLOUTIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
277 MIDDLE TPKE W, MANCHESTER, CT 06040-3834
(860) 432-4640
Mailing address
219 CLEARFIELD RD, WETHERSFIELD, CT 06109-3220
(860) 256-5064
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5299
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/21/2021
Last updated
10/27/2021
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