Berta Alicia Portillo

NPI #1376892190 in Socorro, New Mexico

Provider Information

NPI Number: 1376892190
Entity Type: Individual
Name: Berta Alicia Portillo
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Sep 7, 2012
Last Updated: Sep 13, 2012

Practice Location

Address: 313 HILLTOP
City: Socorro
State: New Mexico
ZIP Code: 87801
Phone: (505) 433-8361

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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