Individual
DR. RUSSELL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
462 SW WARD RD, LEES SUMMIT, MO 64081-2447
(816) 524-5838
Mailing address
462 SW WARD RD, LEES SUMMIT, MO 64081-2447
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2014041284
MO
Other
Enumeration date
03/03/2015
Last updated
06/06/2022
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