MRS. Tina Marie Porta, COTAL

NPI #1154647139 in Macomb, Michigan

Provider Information

NPI Number: 1154647139
Entity Type: Individual
Name: MRS. Tina Marie Porta, COTAL
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Credential: COTAL
Enumeration Date: Apr 15, 2010
Last Updated: Apr 15, 2010

Practice Location

Address: 15618 ETON CT.
City: Macomb
State: Michigan
ZIP Code: 48044
Phone: (586) 791-9204

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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