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1831890706
ELISSA PORT
POMONA, CA
NPI
1831890706
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-03-16
Last Update Date
2023-03-16
Business Address
ELISSA PORT
309 E 2ND ST
POMONA, CA 91766-1854
Phone number: 909-623-6116
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Mailing Address
ELISSA PORT
309 E 2ND ST
POMONA, CA 91766-1854
Phone number: 651-472-2090
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