Individual
MR. MARK CHRISTIAN PORTARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
2125 STATE ST, SUITE 2, NEW ALBANY, IN 47150-4972
(812) 948-2947
(812) 948-4164
Mailing address
2125 STATE ST, SUITE 2, NEW ALBANY, IN 47150-4972
(812) 948-2947
(812) 948-4164
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05003695A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200360530A
—
IN
Enumeration date
07/19/2006
Last updated
12/07/2020
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