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Organization
FAMILY RENEWED, LLC
Active
Organization
FAMILY RENEWED, LLC
Active
Other names
Dawn M. Porter, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWN MICHELLE PORTER MD (FOUNDER/CEO)
(913) 461-0369
Entity
Organization
Contact information
Practice address
1004 PEBBLE BEACH DR, CASEYVILLE, IL 62232-2834
(913) 461-0369
(913) 461-0832
Mailing address
1004 PEBBLE BEACH DR, CASEYVILLE, IL 62232-2834
(913) 461-0369
(913) 461-0832
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
113680
MO
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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