MARY THERESE PORTA

TROY, MI
NPI1174783005
Former NameMARY THERESE GREEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601005244)
Enumeration Date2008-06-13
Last Update Date2022-07-28
Business Address
MARY THERESE PORTA PA-C
44201 DEQUINDRE RD SUITE EC
TROY, MI 48085-1117
Phone number: 248-964-5111
Mailing Address
MARY THERESE PORTA PA-C
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 48033-3849
Phone number: 947-522-1865
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