Provider Demographics
NPI:1316162100
Name:LOUPIN, MICHELLE D (PT)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:D
Last Name:LOUPIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:D
Other - Last Name:DIONNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:32 BOUCHARD DR
Mailing Address - Street 2:
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474-3418
Mailing Address - Country:US
Mailing Address - Phone:207-825-8796
Mailing Address - Fax:
Practice Address - Street 1:133 CORPORATE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4312
Practice Address - Country:US
Practice Address - Phone:207-992-9286
Practice Address - Fax:207-992-9287
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
32901Medicare PIN