Provider Demographics
NPI:1700957263
Name:FORD, DIANE FRANCIS (DIPL AC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:FRANCIS
Last Name:FORD
Suffix:
Gender:F
Credentials:DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREAT FALLS PLAZA UNIT 10
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-5968
Mailing Address - Country:US
Mailing Address - Phone:207-783-2016
Mailing Address - Fax:207-783-2016
Practice Address - Street 1:2 GREAT FALLS PLAZA UNIT 10
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-5968
Practice Address - Country:US
Practice Address - Phone:207-783-2016
Practice Address - Fax:207-783-2016
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC194171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME040632OtherINSURANCE CO