Individual
FATIMA LISSETH CRUZ PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3133 GOLF RIDGE BLVD STE 203, DOUGLASVILLE, GA 30135-1994
(775) 409-8585
Mailing address
7373 BRAMBLE OAK DR, DOUGLASVILLE, GA 30134-5736
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR066528
GA
Other
Enumeration date
02/25/2026
Last updated
02/25/2026
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