Individual
KIMBERLY PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2200 S RURAL RD, TEMPE, AZ 85282-1411
(480) 921-8036
(480) 921-8037
Mailing address
2200 S RURAL RD, TEMPE, AZ 85282-1411
(480) 921-8036
(480) 921-8037
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT-02552
AZ
Other
Enumeration date
12/14/2010
Last updated
12/14/2010
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