Individual
MR. CHEADRICK DEMON PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3004 OAK CREST ST, JASPER, TX 75951-2065
(409) 383-8350
Mailing address
3004 OAK CREST ST, JASPER, TX 75951-2065
(409) 383-8350
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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