Individual
KE'LA HAILEY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
127 CHIPPENHAM CT, CLAYTON, NC 27520-9113
(919) 901-5308
Mailing address
127 CHIPPENHAM CT, CLAYTON, NC 27520-9113
(919) 901-5308
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000032468323
NC
390200000X
Student in an Organized Health Care Education/Training Program
000032468323
NC
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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