Individual
MS. MANDY LYNN PORTER DOSTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., PA-C
Contact information
Practice address
2315 E MORELAND BLVD, WAUKESHA, WI 53186-2939
(262) 532-5700
Mailing address
2711 PRESTON CT, WAUKESHA, WI 53188-4100
(608) 236-4248
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2050023
WI
Other
Enumeration date
11/29/2006
Last updated
08/24/2022
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