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Individual

VICTORIA A DEANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.AC.

Contact information

Practice address
37 FALL BROOK ST, PORTLAND, ME 04103-4224
(908) 268-3552
Mailing address
125 FOREST UNIT 11072, PORTLAND, ME 04104-4239
(908) 268-3552

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AC625
ME
207QS0010X
Sports Medicine (Family Medicine) Physician
AC625
ME
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
AC625
ME

Other

Enumeration date
07/09/2019
Last updated
07/09/2019
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