MR. Derek Port, ATC
NPI #1487004636 in Campbellsville, Kentucky
Provider Information
- NPI Number
- 1487004636
- Entity Type
- Individual
- Name
- MR. Derek Port, ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Jun 20, 2016
- Last Updated
- Jun 20, 2016
Practice Location
- Address
- 1 UNIVERSITY DR
- Address 2
- UPO #823
- City
- Campbellsville
- State
- Kentucky
- ZIP Code
- 42718-2190
- Phone
- (270) 789-5544
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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