Individual
MRS. HENRIETTA A PORTER-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1007 MCCLELLAND AVE, COLUMBUS, OH 43211-2915
(740) 851-7746
Mailing address
1400 EAST BLAKE AVENUE, COLUMBUS, OH 43211
(380) 799-4502
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
02/02/2021
Last updated
09/26/2024
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