Individual
NATHAN E. PORCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
520 HIGH POINT LN, EAST PEORIA, IL 61611-9327
(309) 694-7403
(309) 694-0536
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
(309) 655-7869
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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