Individual
MARY MADISON PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
5513 CHAMBLEE DUNWOODY RD, SUITE 430, DUNWOODY, GA 30338-4106
(770) 551-9633
(770) 698-9184
Mailing address
5513 CHAMBLEE DUNWOODY RD, SUITE 430, DUNWOODY, GA 30338-4106
(770) 551-9633
(770) 698-9184
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
011949
GA
Other
Enumeration date
06/10/2015
Last updated
07/23/2015
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