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Individual

MS. DIANA JEAN KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
211 UNIVERSITY AVE, WESTWOOD, MA 02090-2333
(781) 776-4094
Mailing address
119 UNION ST, EAST WALPOLE, MA 02032-1023
(508) 660-1959

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
4161
CT
363AM0700X
Medical Physician Assistant
PA00638
RI
363AM0700X
Medical Physician Assistant
Primary
PA4293
MA

Other

Enumeration date
06/11/2012
Last updated
09/10/2018
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