Dr. Robert A. Portillo
Chiropractic Sports Physician
3755 Sixes Rd Ste 100
Canton
, Georgia 30114-7856
Dr. Robert A. Portillo
Chiropractic Sports Physician
3755 Sixes Rd Ste 100
Canton
, Georgia 30114-7856
(770) 704-9142
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- Dr. Robert A. Portillo
- 3755 Sixes Rd Ste 100
- Canton, GA
- Zip : 30114-7856
- Fax : (770) 704-9142
- Phone : (770) 704-4580
Second Address
- Dr. Robert A. Portillo
- 3755 Sixes Rd Ste 100
- Canton, GA
- Zip : 30114-7856
- Fax : (770) 704-9142
- Phone : (770) 704-4580
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Is Dr. Robert A. Portillo a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | CHIR007986 | GA |
National Provider Identifier
| NPI | 1306996731 |
|---|---|
| Provider Name | Dr. Robert A. Portillo |
| First Address | Canton, GA 30114-7856 |
| Second Address | Canton, GA 30114-7856 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/01/2007 |
| Last Update Date | 20/11/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.