Camille Porter
Physical Therapist in Providence, UT. Individual provider (NPI-1).
NPI number1881920403
StatusActive
Last updated in NPPESJan 28, 2021
Details
- NPI
- 1881920403
- Entity type
- Individual (NPI-1)
- Name
- Camille Porter
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2009
- Certification date
- Jan 28, 2021
- Last updated
- Jan 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 7362653-2401 | UT | Yes |
| 225100000X | Physical Therapist | PT60117603 | WA |
Practice location
169 N Gateway Dr Ste 160Providence, UT 84332-9882
Phone 435-799-3111 · Fax 435-799-3148
Mailing address
169 N Gateway Dr Ste 160Providence, UT 84332-9882
Phone 435-799-3111 · Fax 435-799-3148
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