JAMIE PORTER

MOLINE, IL
NPI1245648963
Former NameJAMIE EMERSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085005163)
Additional Taxonomies363A00000X Physician Assistant
(Licence: IA  074483)
Enumeration Date2014-07-25
Last Update Date2014-09-04
Business Address
-- JAMIE PORTER
520 VALLEY VIEW DR
MOLINE, IL 61265-6194
Phone number: 309-762-3621
Mailing Address
-- JAMIE PORTER
520 VALLEY VIEW DR
MOLINE, IL 61265-6194
Phone number: 309-762-3621