JACK PORTER

FRESNO, CA
NPI1780734574
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-01-12
Last Update Date2007-07-08
Business Address
-- JACK PORTER
3707 E SHIELDS AVE
FRESNO, CA 93726-7029
Phone number: 559-229-9040
Mailing Address
-- JACK PORTER
970 MAKENNA ST
LEMOORE, CA 93245-4502
Phone number: 559-924-0663
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