Individual
SHELLEY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LRD
Contact information
Practice address
900 E BROADWAY AVENUE, BISMARCK, ND 58501
(701) 530-7000
(701) 530-8842
Mailing address
900 E BROADWAY AVENUE, P.O. BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
28
ND
Other
Enumeration date
02/16/2007
Last updated
07/31/2010
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