Individual
MS. ELIZABETH COOPER PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
210 TRADITIONS AVE, BOWLING GREEN, KY 42103
(606) 303-8634
(317) 520-8200
Mailing address
210 AUGUSTA AVE, BOWLING GREEN, KY 42103-2537
(606) 303-8634
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
132707
KY
225XP0200X
Pediatric Occupational Therapist
RO183
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100332170
—
KY
Enumeration date
11/28/2011
Last updated
07/01/2022
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