Heather Roan Porter PTA

NPI 1336116615 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1336116615
Gender Female
Enumeration Date 03/04/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
510 W PALOUSE RIVER DR
MOSCOW ID, 83843-8901, US
Phone (208) 882-1570
Fax (208) 883-4400
Business Location
492 W TAYLOR AVE
APT 4
MOSCOW ID, 83843-2349, US
Phone (208) 882-1570
Fax (208) 883-4400
Toxanomy
Taxonomy Code 225200000X
License State Idaho
License Number PTA-333
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According to our database, Mrs. Heather Roan Porter PTA NPI is 1336116615, taxonomy code is 225200000X and license number is PTA-333, license state is located at Idaho. Heather Roan Porter PTA physically located at 510 W Palouse River Dr, Moscow ID, 83843-8901. NPI Number Heather Roan Porter PTA has the Individual type.

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1336116615 NPI number is provided on an as is basis without warranty of any kind. 1336116615 is maintained by the National Plan & Provider Enumeration System. The contents of Heather Roan Porter PTA are for informational purposes only.