Individual
KATHLEEN L PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10641 E MINNESOTA AVE, SUN LAKES, AZ 85248-8843
(480) 322-4981
Mailing address
10641 E MINNESOTA AVE, SUN LAKES, AZ 85248-8843
(808) 282-3355
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MAT-15262
HI
225700000X
Massage Therapist
Primary
MT-25051
AZ
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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