Individual
LAURA PORCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPISTY
Contact information
Practice address
212 S 3RD ST, ROGERS, AR 72756-4547
(147) 963-1351
Mailing address
1400 NE DYSART WOODS LN, BENTONVILLE, AR 72712-8591
(479) 531-8329
(147) 971-5687
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2928
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161694721
—
AR
01
—
5A044
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/22/2006
Last updated
08/13/2009
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