Individual
DION DE KOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2300 CONGRESS ST, PORTLAND, ME 04102-1908
(207) 221-2292
(207) 221-2297
Mailing address
2300 CONGRESS ST, PORTLAND, ME 04102-1908
(207) 221-2292
(207) 221-2297
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN14399
ME
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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