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Individual

MARIE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5724 ALTEN ST, PORTAGE, MI 49024
(269) 779-8488
Mailing address
5724 ALTEN ST, PORTAGE, MI 49024-8113

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
08/04/2015
Last updated
08/04/2015
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