Individual
MRS. MARIELLEN L PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.M.T.
Contact information
Practice address
RR 2 BOX 2172-A, PINE RIDGE ROAD, EAST STROUDSBURG, PA 18301-9636
(570) 223-2204
(570) 223-7221
Mailing address
RR 2 BOX 2172-A, PINE RIDGE ROAD, EAST STROUDSBURG, PA 18301-9636
(570) 223-2204
(570) 223-7221
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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