Individual
DAWN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, ATC
Contact information
Practice address
555 VALLEY VIEW DR, MOLINE, IL 61265-6138
(309) 764-9675
Mailing address
4410 N LINCOLN AVE, DAVENPORT, IA 52806-4930
(563) 449-6056
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006737
IL
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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