Individual
MICHAEL VINCENT PORTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
500 W ELK GROVE BLVD, ELK GROVE VILLAGE, IL 60007-4272
(847) 718-4507
Mailing address
1905 STORMY CT, APT 201, SCHAUMBURG, IL 60193-5197
(847) 975-8575
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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