Organization
LESLIE PORTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DIANE PORTER OTR/L (PRESIDENT)
(501) 786-2800
Entity
Organization
Contact information
Practice address
1624 N POLK ST, LITTLE ROCK, AR 72207-5328
(501) 786-2800
Mailing address
1624 N POLK ST, LITTLE ROCK, AR 72207-5328
(501) 786-2800
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180492721
—
AR
Enumeration date
02/02/2023
Last updated
02/02/2023
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