Individual
KALEB TODD PORTZLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
Mailing address
814 MOOSIC HTS, AVOCA, PA 18641-9507
(570) 898-4816
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW138360
PA
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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