Individual
LATISHIA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14491 EDMORE DR, DETROIT, MI 48205-1259
(313) 529-2084
Mailing address
14491 EDMORE DR, DETROIT, MI 48205-1259
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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