Individual
DR. PORSHE TIARA MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1050 SHILOH RD NW STE 303, KENNESAW, GA 30144-7197
(770) 370-7588
Mailing address
2020 POWERS FERRY RD SE UNIT 1566, ATLANTA, GA 30339-5158
(901) 603-2623
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO010689
GA
Other
Enumeration date
02/27/2022
Last updated
10/03/2022
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