Provider Demographics
NPI:1932237930
Name:PORITZ, JEFFEREY S (DC)
Entity Type:Individual
Prefix:
First Name:JEFFEREY
Middle Name:S
Last Name:PORITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15639
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416
Mailing Address - Country:US
Mailing Address - Phone:800-679-7246
Mailing Address - Fax:912-355-1848
Practice Address - Street 1:7731 ULMERTON RD
Practice Address - Street 2:UNIT 4
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-4574
Practice Address - Country:US
Practice Address - Phone:800-679-7246
Practice Address - Fax:912-355-1848
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor