Individual
DR. IAN DAVID PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
605 VALLEY HILL RD SW, RIVERDALE, GA 30274-2445
(678) 545-2020
Mailing address
605 VALLEY HILL RD SW, RIVERDALE, GA 30274-2445
(678) 545-2020
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR007561
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIR007561
DOCTOR OF CHIROPRACTIC
GA
Enumeration date
09/15/2021
Last updated
09/15/2021
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