Individual
DEMI BREANNA PORTER GARZA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5892 STERLING DR, HOWELL, MI 48843-8861
(623) 693-9600
Mailing address
7429 W MELINDA LN, GLENDALE, AZ 85308-9529
(623) 693-9600
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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