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Individual

MS. PAM A PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1207 MAIN ST, DAPHNE, AL 36526-4420
(251) 621-6865
(251) 621-6891
Mailing address
44 RAMEY LN, FAIRHOPE, AL 36532-2078
(251) 401-0950
(251) 621-6891

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PTH1459
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51033114
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/25/2006
Last updated
08/05/2025
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