Individual
MONTEZ PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2823 N 36TH ST, MILWAUKEE, WI 53210-1925
(414) 231-0644
Mailing address
2823 N 36TH ST, MILWAUKEE, WI 53210-1925
(414) 231-0644
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
—
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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