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Individual

ANDREW RYAN PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC., M.T.C.M.

Contact information

Practice address
710 RIVER ST, SUITE 11, SANTA CRUZ, CA 95060-2748
(907) 317-1511
Mailing address
127 NATIONAL ST, SANTA CRUZ, CA 95060-6516
(907) 317-1511

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
17279
CA

Other

Enumeration date
10/10/2016
Last updated
10/10/2016
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