Individual
COLLEEN GRADY PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
123 AMHERST ST, WINCHESTER, VA 22601-4137
(540) 532-5312
Mailing address
123 AMHERST ST, WINCHESTER, VA 22601-4137
(540) 532-5312
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0121000794
VA
Other
Enumeration date
06/03/2016
Last updated
06/03/2021
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