Individual
KATIE M PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
2000 N DEWEY AVE, REEDSBURG, WI 53959-1049
(608) 524-6487
Mailing address
2000 N DEWEY AVE, REEDSBURG, WI 53959-1049
(608) 524-6487
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7741-23
WI
363A00000X
Physician Assistant
PA2014-0086
NM
Other
Enumeration date
02/16/2012
Last updated
05/03/2024
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