Individual
PHILIP W PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6264 E GRANT RD, TUCSON, AZ 85712-5882
(520) 884-0001
(520) 884-0199
Mailing address
2850 N COUNTRY CLUB RD, TUCSON, AZ 85716-1910
(520) 322-6274
(520) 509-4496
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
32180
AZ
225100000X
Physical Therapist
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109503
—
AZ
01
—
32180
LPT LICENSE
AZ
Enumeration date
01/04/2022
Last updated
07/15/2022
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