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1740511823
MISTY D PORTER
JACKSONVILLE, FL
NPI
1740511823
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2010-01-29
Last Update Date
2010-01-29
Business Address
-- MISTY D PORTER B.A.
910 N JEFFERSON ST
JACKSONVILLE, FL 32209-6810
Phone number: 904-360-7022
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Mailing Address
-- MISTY D PORTER B.A.
431 SHAMROCK RD
ST AUGUSTINE, FL 32086-6561
Phone number: 904-360-7022
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