Individual
MR. JAMARR ANTIONNE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
08175
MD
225X00000X
Occupational Therapist
OC015136
PA
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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