Individual
CHRIS POORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1882 BAYLEY DR APT 164, LAFAYETTE, IN 47905-8619
(317) 658-2641
Mailing address
1882 BAYLEY DR APT 164, LAFAYETTE, IN 47905-8619
(317) 658-2641
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004746A
IN
Other
Enumeration date
11/27/2013
Last updated
11/27/2013
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