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Individual

ROYCE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
250 W 300 N, ROOSEVELT, UT 84066-2336
(435) 725-7448
Mailing address
749 S HARRISON DR, APT C3, ROOSEVELT, UT 84066-3425

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9140432-4201
UT

Other

Enumeration date
02/16/2015
Last updated
02/16/2015
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