Individual
MICHELLE M. PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
211 S 9TH ST, 6TH FLOOR WALNUT TOWERS, PHILADELPHIA, PA 19107-6810
(215) 955-1925
(215) 928-3160
Mailing address
211 S 9TH ST, SUITE 600, PHILADELPHIA, PA 19107-6810
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
DN004010
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102969883
—
PA
Enumeration date
01/04/2011
Last updated
04/27/2016
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