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Individual

DR. JOHN MICHAEL PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D

Contact information

Practice address
360 NORTHSIDE DR E, STATESBORO, GA 30458-4839
(912) 764-9147
(912) 764-7219
Mailing address
PO BOX 1009, 360 NORTHSIDE DR. E, STATESBORO, GA 30459-1009
(912) 764-9147
(912) 764-7219

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001822
GA

Other

Enumeration date
04/05/2006
Last updated
02/01/2008
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