JACOB RUSSELL PORTER

SALT LAKE CITY, UT
NPI1588198063
Professional NameJACOB RUSSELL PORTER
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  00000000)
Enumeration Date2017-04-12
Last Update Date2020-08-18
Business Address
JACOB RUSSELL PORTER D.O
333 N 300 W
SALT LAKE CITY, UT 84103-1215
Phone number: 014-637-4158
Mailing Address
JACOB RUSSELL PORTER D.O
333 N 300 W
SALT LAKE CITY, UT 84103-1215
Phone number: 480-318-0354
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