MEDICARE: DEBORAH PORTER-JONES LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	17997	NC

General Provider Information

NPI Number	:	1861187577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH PORTER-JONES LMT

Provider Business Mailing Address
First Line	:	8618 GALENA VIEW DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-7180
Country	:	US
Telephone Number	:	267-303-9998
Fax Number	:

Provider Business Practice Location Address
First Line	:	8618 GALENA VIEW DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-7180
Country	:	US
Telephone Number	:	267-303-9998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2023
Last Update Date	:	04/07/2023

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