Individual
DR. LEVI MARC PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
16331 HERITAGE PL, STE 104, EAGLE RIVER, AK 99577-7753
(907) 753-7515
(907) 753-7585
Mailing address
16331 HERITAGE PL, STE 104, EAGLE RIVER, AK 99577-7753
(503) 504-6941
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
249T
AK
152W00000X
Optometrist
299T
WY
152W00000X
Optometrist
3145AT
OR
Other
Enumeration date
06/20/2006
Last updated
10/04/2017
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