Individual
ASHLY PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 MAPLE HILL AVE STE 1, PETERSBURG, WV 26847-1547
(540) 405-4644
Mailing address
21 BRAKES LOOP, PETERSBURG, WV 26847-8819
(304) 257-9298
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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