Individual
DR. MICHAEL JOHN PORTONOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
943 NORTH CHURCH STREET, HAZLETON, PA 18201
(570) 401-1916
Mailing address
943 N CHURCH ST, HAZLETON, PA 18201-1800
(570) 861-8502
(570) 861-8170
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 010381
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12215846
CAQH
—
Enumeration date
02/09/2010
Last updated
10/21/2015
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