Organization
FAMILY RENEWED, LLC
Active
Other names
Dawn M. Porter, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWN MICHELLE PORTER MD (FOUNDER/CEO)
(913) 461-0369
Entity
Organization
Contact information
Practice address
1004 PEBBLE BEACH DR, CASEYVILLE, IL 62232-2834
(913) 461-0369
(913) 461-0832
Mailing address
1004 PEBBLE BEACH DR, CASEYVILLE, IL 62232-2834
(913) 461-0369
(913) 461-0832
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
113680
MO
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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