Individual
MRS. MICHELLE M PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
121 S. CHRISTIAN AVE., MOUNDRIDGE, KS 67107-0743
(620) 345-3000
(620) 345-3042
Mailing address
121 S. CHRISTIAN, PO BOX 743, MOUNDRIDGE, KS 67107-0743
(620) 345-3000
(620) 345-3042
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
17-01284
KS
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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