Individual
MANDI LASHEA PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(662) 244-2074
Mailing address
4092 MERRILLVILLE DR. APT 14105, WEST MELBOURNE, FL 32904
(707) 514-5037
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
00010707
WA
225100000X
Physical Therapist
Primary
34857
CA
225100000X
Physical Therapist
5038
MS
Other
Enumeration date
08/13/2008
Last updated
04/15/2021
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