Individual
KAREN ANNE PORTER
Active
Individual
KAREN ANNE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4381-024
WI
225100000X
Physical Therapist
Primary
PT011776
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
392039073012
BLUE CROSS/BLUE SHIELD ID
WI
Enumeration date
10/04/2006
Last updated
03/17/2018
Update your record
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