Individual
BROOKE ELIZABETH PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 HOSPITAL DR RM M349, COLUMBIA, MO 65212-1000
(573) 882-2275
Mailing address
1 HOSPITAL DR RM M349, COLUMBIA, MO 65212-1000
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
2020017452
MO
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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