Individual
THERESA ANN PORTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
24 WHITAKER AVE, NORTH EAST, MD 21901-2643
(302) 275-7560
Mailing address
24 WHITAKER AVE, NORTH EAST, MD 21901-2643
(302) 275-7560
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/17/2008
Last updated
11/07/2011
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