Individual
JENNIFER IDALIA PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 MILITARY ROAD, BENTON, AR 72015
(501) 778-3151
Mailing address
1525 MILITARY ROAD, BENTON, AR 72015
(501) 778-3151
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD17403
AR
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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