Individual
KIP C PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
275 S MAIN ST, TOOELE, UT 84074-2743
(435) 833-0977
(435) 833-0978
Mailing address
275 S MAIN ST, TOOELE, UT 84074-2743
(435) 833-0977
(435) 833-0978
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3361041202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
639967
DMBA
UT
01
—
QM0000044527
ALTIUS
UT
Enumeration date
08/25/2006
Last updated
12/11/2007
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