Individual
DR. MARIO MANUEL PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
20860 N TATUM BLVD STE 290, PHOENIX, AZ 85050-4282
(480) 563-1144
(480) 563-2371
Mailing address
1839 S ALMA SCHOOL RD STE 354, MESA, AZ 85210-3028
(480) 726-2287
(888) 316-9272
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8652
AZ
111NR0400X
Rehabilitation Chiropractor
8652
AZ
Other
Enumeration date
07/26/2017
Last updated
02/28/2023
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