Individual
TYLER PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1715 CLEVELAND AVE. APT. 2F, WHITING, IN 46394
(219) 386-9175
Mailing address
1715 CLEVELAND AVE APT 2F, WHITING, IN 46394-1651
(219) 386-9175
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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