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Individual

PATRICK DA'VON PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4975 DUNEVILLE ST APT 325, LAS VEGAS, NV 89118-1272
(702) 417-4139
Mailing address
4975 DUNEVILLE ST APT 325, LAS VEGAS, NV 89118-1272

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
NV

Other

Enumeration date
03/14/2020
Last updated
03/14/2020
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