Individual
CLYDE WILLIAM PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1005 TERMINAL WAY STE 270, RENO, NV 89502-2181
(775) 331-0177
(775) 331-8391
Mailing address
PO BOX 20788, RENO, NV 89515-0788
(775) 331-0177
(775) 331-8391
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
B115
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88-0178222
NEVADA TAX ID
NV
Enumeration date
08/31/2006
Last updated
09/26/2018
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