Individual
LILLIAN PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
930 NEW HOPE RD, LAWRENCEVILLE, GA 30045-6407
(770) 682-2433
Mailing address
588 MARTHA SUE DRIVE, LAWRENCEVILLE, GA 30045
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031494
GA
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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