Provider Demographics
NPI:1003870569
Name:CLOUTIER, AARON DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:DAVID
Last Name:CLOUTIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10912
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04104-6912
Mailing Address - Country:US
Mailing Address - Phone:207-450-3733
Mailing Address - Fax:
Practice Address - Street 1:3B ABENAKI PROFESSIONAL PARK
Practice Address - Street 2:RT 1
Practice Address - City:WELLS
Practice Address - State:ME
Practice Address - Zip Code:04090
Practice Address - Country:US
Practice Address - Phone:207-641-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR 1276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME 0509Medicare ID - Type Unspecified