Individual
MS. DIANE MARION REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
417 STATE STREET, WEBBER EAST, SUITE 310, BANGOR, ME 04401-1000
(207) 973-9351
(207) 973-9358
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
(207) 945-5427
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA587
ME
Other
Enumeration date
01/22/2007
Last updated
09/17/2021
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