Mrs. HEATHER ROAN PORTER PTA
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1336116615- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PTA
- Status
- Active
Contact & Location
- Address
- 1503 LINDELL BLVD, GRANITE CITY, IL, 620403837
- Phone
- (618) 709-4125
Specialties & Taxonomies
Physical Therapy Assistant
License: ID #PTA-333
Physical Therapy Assistant
License: MO #2020010583
Physical Therapy Assistant
Primary License: IL #160.008943