Individual
DIANE SANFORD KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST AS-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2241
Mailing address
15 ARLINGTON RD, SOUTH PORTLAND, ME 04106-4802
(207) 799-6968
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
C06-1206A
ME
246ZS0410X
Surgical Technologist
C06-1206A
—
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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