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1689672479
THEODORE B PORTER
PHILADELPHIA, PA
NPI
1689672479
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: PA OS003735L)
Enumeration Date
2005-07-14
Last Update Date
2013-03-12
Business Address
-- THEODORE B PORTER D.O.
1413 W MOYAMENSING AVE 1ST FLOOR
PHILADELPHIA, PA 19145-4625
Phone number: 267-639-2555
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Mailing Address
-- THEODORE B PORTER D.O.
1413 W MOYAMENSING AVE 1ST FLOOR
PHILADELPHIA, PA 19145-4625
Phone number: 267-639-2555
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