Doctor Name: | MARY MADISON PORTER |
NPI Number: | 1942681432 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT |
License Number: | 011949 |
Business Practice Address: | 5513 Chamblee Dunwoody Rd Suite 430 Dunwoody, GA - 303384106 |
Business Phone Number: | 7705519633 |
Business Fax Number: | 7706989184 |
Mailing Address: | 5513 Chamblee Dunwoody Rd, Suite 430 DUNWOODY |
State: | GA |
Postal Code: | 303384106 |
Phone Number: | 7705519633 |
Fax Number: | 7706989184 |
NPI Enumeration Date: | 06/10/2015 |
NPI Last Update Date: | 07/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 011949 |
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 |