Individual
DR. DWAIN PHILLIP PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
717 WHEATLEY ROAD, ASHLAND, KY 41101
(606) 329-1148
(606) 324-6408
Mailing address
3201 LOWMAN DR, ASHLAND, KY 41102-5785
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4264
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000211930
ANTHEM
KY
01
—
5274435
AETNA
KY
05
—
85036382
—
KY
Enumeration date
11/13/2006
Last updated
07/08/2007
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