Individual
TIMOTHY RAY PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1159 COUNTY ROAD 411, PROCTORVILLE, OH 45669-9409
(740) 861-9171
Mailing address
1159 COUNTY ROAD 411, PROCTORVILLE, OH 45669-9409
(740) 861-9171
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
OH
376J00000X
Homemaker
—
—
Other
Enumeration date
08/16/2024
Last updated
03/10/2025
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