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Individual

L JON PORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1425 W ELLIOT RD, STE 203, GILBERT, AZ 85233-5129
(480) 812-9000
Mailing address
319 W VERANO PL, GILBERT, AZ 85233-7331
(480) 545-7270

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
5435
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0932790
BLUECROSS BLUESHIELD
AZ
Enumeration date
04/20/2007
Last updated
07/08/2007
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