Individual
DR. JUAN PORTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 927, LAS VEGAS, NM 87701-0927
(505) 459-8118
Mailing address
PO BOX 927, LAS VEGAS, NM 87701-0927
(505) 459-8118
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C-11944
NM
225100000X
Physical Therapist
436493
NM
225X00000X
Occupational Therapist
Primary
436551
NM
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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