Individual
JACOB ALLEN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
65347 LAKE RD LOT B, CAMBRIDGE, OH 43725-8519
(740) 801-2983
Mailing address
13351 CONQUER HILL RD, BYESVILLE, OH 43723-9683
(740) 801-2983
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
UT786433
OH
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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