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Individual

JULIA AMANDA PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, ATC, LAT, CSCS

Contact information

Practice address
481 BURRAGE RD NE, CONCORD, NC 28025-2623
(704) 786-4161
(704) 782-7539
Mailing address
481 BURRAGE RD NE, CONCORD, NC 28025-2623
(704) 786-4161
(704) 782-7539

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1036
NC

Other

Enumeration date
06/25/2016
Last updated
06/25/2016
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