Individual
MR. RUSSELL PORRAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7102 NOVAS LNDG, SELLERSBURG, IN 47172-1899
(812) 590-9181
(502) 498-5388
Mailing address
7102 NOVAS LNDG, SELLERSBURG, IN 47172-1899
(812) 590-9181
(502) 498-5388
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008378A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200952750
—
IN
Enumeration date
07/15/2008
Last updated
03/07/2016
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