Individual
MRS. AMANDA LOGAN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
726 YORKLYN ROAD, SUITE 100, HOCKESSIN, DE 19707-0000
(302) 234-5770
(302) 234-5777
Mailing address
726 YORKLYN RD, SUITE 100, HOCKESSIN, DE 19707-8744
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C5-0000603
DE
Other
Enumeration date
11/05/2007
Last updated
01/02/2014
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