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Organization

GLEN T. PORTER, MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLEN PORTER M.D. (PRESIDENT)
(702) 806-6826
Entity
Organization

Contact information

Practice address
1159 E 200 N, STE 325, AMERICAN FORK, UT 84003-2022
(801) 756-5291
Mailing address
1159 E 200 N, STE 325, AMERICAN FORK, UT 84003-2022

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
7133786-1205
UT

Other

Enumeration date
03/19/2009
Last updated
03/19/2009
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