Individual
DR. EDWARD PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 256-1901
Mailing address
2500 OVERLOOK TER, MADISON, WI 53705-2254
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17505 - 40
WI
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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