Provider Demographics
NPI:1740217231
Name:ALFORD, JOAN E (RD, LD, CDE)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:ALFORD
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BORSKIS WAY
Mailing Address - Street 2:
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578-4715
Mailing Address - Country:US
Mailing Address - Phone:207-373-2170
Mailing Address - Fax:207-373-2184
Practice Address - Street 1:329 MAINE ST
Practice Address - Street 2:PARKVIEW ADVENTIST MEDICAL CENTER
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3310
Practice Address - Country:US
Practice Address - Phone:207-373-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI874133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered