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1497453955
WACO C PORTER
OLATHE, KS
NPI
1497453955
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: KS 14-03569)
Enumeration Date
2023-02-22
Last Update Date
2023-02-22
Business Address
Mr. WACO C PORTER
11032 S GREEN RD
OLATHE, KS 66061-5657
Phone number: 816-547-9654
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Mailing Address
Mr. WACO C PORTER
6713 VERMONT AVE
RAYTOWN, MO 64133-6140
Phone number: 816-809-8086
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