Healthcare Provider Details

I. General information

NPI: 1003870569
Provider Name (Legal Business Name): AARON DAVID CLOUTIER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3B ABENAKI PROFESSIONAL PARK RT 1
WELLS ME
04090
US

IV. Provider business mailing address

PO BOX 10912
PORTLAND ME
04104-6912
US

V. Phone/Fax

Practice location:
  • Phone: 207-641-2233
  • Fax:
Mailing address:
  • Phone: 207-450-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCR 1276
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: