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Individual

MR. DWIGHT WENISLOW PORTER SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPSS

Contact information

Practice address
1852 WEST GRAND BLVD, DETROIT, MI 48208
(313) 894-8444
(313) 894-5542
Mailing address
1852 WEST GRAND BOULEVARD, DETROIT, MI 48208
(313) 894-8444
(313) 894-5542

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
02/22/2022
Last updated
02/22/2022
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