Healthcare Provider Details

I. General information

NPI: 1457281016
Provider Name (Legal Business Name): ELLA MCGUIRK DACM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 BRIDGE ST STE 4163
WESTBROOK ME
04092-2952
US

IV. Provider business mailing address

88 GREENWOOD LN
PORTLAND ME
04103-1667
US

V. Phone/Fax

Practice location:
  • Phone: 207-205-6804
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC876
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: