Individual
IAN DAVID PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 NE 13TH ST, OKLAHOMA CITY, OK 73117-1022
(405) 248-9368
Mailing address
3425 ROYALWOOD CIR, DEL CITY, OK 73115-1745
(253) 341-3059
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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