Individual
JUSTIN TERRY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
380 CHASE AVE, WALLA WALLA, WA 99362-2924
(509) 897-8600
Mailing address
2994 BARNEY RD, TOUCHET, WA 99360-9681
(509) 540-9137
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160857473
WA
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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