Individual
CAMILLE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
169 N GATEWAY DR STE 160, PROVIDENCE, UT 84332-9882
(435) 799-3111
(435) 799-3148
Mailing address
169 N GATEWAY DR STE 160, PROVIDENCE, UT 84332-9882
(435) 799-3111
(435) 799-3148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7362653-2401
UT
225100000X
Physical Therapist
PT60117603
WA
Other
Enumeration date
11/02/2009
Last updated
01/28/2021
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