Individual
PORTER PAVALKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
615 S NEW BALLAS RD STE G400, SAINT LOUIS, MO 63141-8221
(314) 251-4863
Mailing address
615 S NEW BALLAS RD # G400, SAINT LOUIS, MO 63141-8221
(314) 251-4863
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/23/2019
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