Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Jeremy Porter

Individual provider Massage Therapist · NPI 1104730860

Jeremy Porter is a Massage Therapist in Mishawaka, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2026

Practice location Address checks out

229 Red Coach Dr Ste 107
Mishawaka, IN 46545-3195
Phone: (574) 318-7800
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MT22608995 (IN)

Record details

NPI number1104730860
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 30, 2026
Last updated in NPPESSeptember 30, 2026
Certification dateSeptember 30, 2026

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