Individual
NICHELLE TRAXLER PORTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
228 SILVERLEAF DR, STERLING, VA 20164-2847
(703) 966-3637
Mailing address
228 SILVERLEAF DR, STERLING, VA 20164-2847
(703) 966-3637
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002929
VA
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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