Doctor Name: | MARVAN HOWARD PORTER |
NPI Number: | 1134459209 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT009830 |
Business Practice Address: | 495 Winn Way Decatur, GA - 300301736 |
Business Phone Number: | 4043890077 |
Business Fax Number: | |
Mailing Address: | 6578 Chestnut Oaks Rdg, LITHONIA |
State: | GA |
Postal Code: | 300384571 |
Phone Number: | 7703231567 |
Fax Number: | |
NPI Enumeration Date: | 01/12/2010 |
NPI Last Update Date: | 01/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT009830 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |