JONATHON THOMAS PORTARO

DETROIT, MI
NPI1982410049
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: MI  4704330807)
Enumeration Date2024-12-04
Last Update Date2025-02-14
Business Address
Mr. JONATHON THOMAS PORTARO NP
11105 E JEFFERSON AVE
DETROIT, MI 48214-3317
Phone number: 313-821-4238
Mailing Address
Mr. JONATHON THOMAS PORTARO NP
1105 E JEFFERSON
DETROIT, MI 48214
Phone number: 586-381-8306