Individual
CATHY LURLYNE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1170 PROSSER RD, LEOMA, TN 38468-5050
(760) 285-1607
Mailing address
1170 PROSSER RD, LEOMA, TN 38468-5050
(760) 285-1607
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OT004969
GA
172V00000X
Community Health Worker
OT2743
CO
172V00000X
Community Health Worker
OT8282
CA
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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