Individual
DIANA MAINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
31 MAPLE ST, CORNISH, ME 04020-3101
(207) 619-0994
Mailing address
72 JOE BERRY RD, CORNISH, ME 04020-3720
(207) 310-3897
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT5477
ME
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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