Individual
DR. JASON PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3269 N STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 681-8701
Mailing address
1840 W ARROW RTE APT 98, UPLAND, CA 91786-7669
(909) 630-1980
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
R4140
CA
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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