Individual
CHRISTOPHER TALIS PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
2275 RUIN CREEK RD, HENDERSON, NC 27537-8732
(252) 325-4535
Mailing address
3725 SOUTH BLVD, VIRGINIA BEACH, VA 23452-3355
(757) 575-7853
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605246
VA
Other
Enumeration date
01/02/2019
Last updated
01/02/2019
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