Individual
THERESA A. PORCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDMS, RVT, RDCS
Contact information
Practice address
1076 W HAYDEN AVE, HAYDEN, ID 83835-8793
(208) 772-2823
Mailing address
807 W LAKESHORE DR, COEUR D ALENE, ID 83814-2131
(208) 661-2366
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
3082
MD
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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