Individual
ALYSSA JOY DIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
235 HIGH ST, ELLSWORTH, ME 04605-1715
(207) 412-5200
Mailing address
360 US HIGHWAY 1 BYP UNIT 102, PORTSMOUTH, NH 03801-7105
(603) 410-6700
(603) 319-8308
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2236
ME
Other
Enumeration date
08/25/2021
Last updated
11/15/2023
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