Individual
TERESA IRENE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA-01110
Contact information
Practice address
66 NORWOOD AVE, NORWALK, OH 44857-2337
(440) 396-6085
Mailing address
7585 PYLE SOUTH AMHERST RD, AMHERST, OH 44001-2123
(440) 396-6085
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OTA 01110
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA 01110
THERAPY
OH
Enumeration date
07/03/2012
Last updated
07/03/2012
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