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Individual

MR. JOSHUA WILLIAM PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., L.A.T., A.T.C.

Contact information

Practice address
1810 MANNING WAY, UNIVERSITY, MS 38677-1848
(662) 915-7536
(662) 915-5275
Mailing address
PO BOX 1848, UNIVERSITY, MS 38677-1848
(662) 915-7536
(662) 915-5275

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0639
MS

Other

Enumeration date
07/07/2010
Last updated
12/03/2014
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