| Organization Name: | POULIN PERFORMANCE, INC. |
| NPI Number: | 1174553283 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA AUDETTE CRITCHLOW (PRACTICE ADMINISTRATOR) |
| Mailing Address: | 21 Gregory Dr Suite 120 South Burlington |
| State: | VT US |
| Postal Code: | 054036080 |
| Phone Number: | 8026580949 |
| Fax Number: | 8026581436 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 10/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 040-0002746 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |