Individual
MR. JOSHUA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
979 E 3RD ST STE C225, CHATTANOOGA, TN 37403-3314
(423) 778-5995
(423) 778-5994
Mailing address
975 E. THIRD STREET, ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403-3314
(423) 778-5995
(423) 778-5994
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3344
TN
Other
Enumeration date
09/15/2011
Last updated
08/09/2017
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