Individual
HARRY JACOB PORTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1550 COLLEGE ST, MACON, GA 31207-0001
(478) 301-2531
Mailing address
1550 COLLEGE ST, MACON, GA 31207-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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