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Individual

DR. ROBERT A. PORTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
3755 SIXES RD STE 100, CANTON, GA 30114-7856
(770) 704-4580
(770) 704-9142
Mailing address
3755 SIXES RD STE 100, CANTON, GA 30114-7856
(770) 704-4580
(770) 704-9142

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
CHIR007986
GA

Other

Enumeration date
01/10/2007
Last updated
11/20/2019
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