JUSTIN GABRIEL PORTA

FAYETTEVILLE, AR
NPI1124332267
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225XP0200X Occupational Therapist Pediatrics
(Licence: AR  OTR1632)
Enumeration Date2010-07-30
Last Update Date2010-07-30
Business Address
JUSTIN GABRIEL PORTA OTR/L
538 N MONROE STATION DR
FAYETTEVILLE, AR 72704-7038
Phone number: 479-466-7134
Mailing Address
JUSTIN GABRIEL PORTA OTR/L
538 N MONROE STATION DR
FAYETTEVILLE, AR 72704-7038
Phone number: 479-466-7134
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