Individual
ANGELA RAYLYNNE PORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1555 INDUSTRIAL DR, OWOSSO, MI 48867-9775
(989) 506-1109
Mailing address
611 WALNUT ST, CORUNNA, MI 48817-1001
(989) 506-1109
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007653
MI
Other
Enumeration date
03/22/2011
Last updated
07/06/2023
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