Individual
KAYLA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 WILDCAT WAY, LOGAN, WV 25601-3474
(304) 752-1804
Mailing address
506 HOLLY AVE, LOGAN, WV 25601-3306
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
109682
WV
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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