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General NPI Number Information
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NPI Number | 1952871873
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Entity Type | Organization
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Legal Business Name | J . PORTER SERVICES LLC
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Dates
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Enumeration Date | 12/04/2018
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 17320 LIVERNOIS AVE
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City | DETROIT
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State | MI
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Zip | 48221-2759
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Country | US
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Telephone | 248-327-6129
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Fax |
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Provider Business Mailing Address
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Address Line | 18037 TEPPERT ST
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City | DETROIT
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State | MI
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Zip | 48234-3858
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Country | US
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Telephone | 313-574-3784
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | J'NAI L PORTER
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Credential | LMT
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Telephone | 313-574-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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