Individual
JUSTIN PAUL PORTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
333 N EMERALD DR, APT 77, VISTA, CA 92083-6156
(513) 503-3873
Mailing address
333 N EMERALD DR, APT 77, VISTA, CA 92083-6156
(513) 503-3873
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/20/2015
Last updated
06/02/2015
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