Individual
MADELYNE KAYE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5057 W 3450 S, WEST HAVEN, UT 84401-8826
(757) 771-6783
Mailing address
4339 S 2350 W, ROY, UT 84067-2013
(757) 771-6783
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
148704
AK
225700000X
Massage Therapist
Primary
9505343-4701
UT
Other
Enumeration date
09/23/2019
Last updated
11/20/2025
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