Individual
MISS ANDREA LEIGH PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4645 BELPAR ST NW, CANTON, OH 44718-3602
(330) 493-4210
(330) 493-4744
Mailing address
353 26TH ST SE, MASSILLON, OH 44646-5087
(330) 933-8968
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-08525
OH
Other
Enumeration date
08/01/2012
Last updated
08/05/2012
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