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Individual

MEMORY PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
817 MAIN ST, ADEL, IA 50003-1478
(515) 993-2170
(515) 993-2174
Mailing address
817 MAIN ST, ADEL, IA 50003-1478
(515) 993-2170
(515) 993-2174

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3575
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0665430
IA
Enumeration date
10/25/2006
Last updated
08/20/2025
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