MEDICARE: MRS. ROBYN SCOT PORTER P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	837	AR

General Provider Information

NPI Number	:	1023258233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBYN SCOT PORTER P.T.

Provider Business Mailing Address
First Line	:	36 OAK TREE CIR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7006
Country	:	US
Telephone Number	:	501-812-5251
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 OAK TREE CIR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7006
Country	:	US
Telephone Number	:	501-812-5251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2009
Last Update Date	:	02/27/2009

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