Individual
ADRIAN LEONARDO PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112-5888
(385) 272-2161
Mailing address
5641 W FALLEN OAK RD, WEST VALLEY CITY, UT 84118-6060
(385) 272-2161
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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