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1245287010
GEORGE A PORTILLA
DETROIT LAKES, MN
NPI
1245287010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: MN 27750)
Enumeration Date
2006-05-27
Last Update Date
2011-11-21
Business Address
-- GEORGE A PORTILLA MD
1027 WASHINGTON AVE
DETROIT LAKES, MN 56501-3409
Phone number: 218-847-5611
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Mailing Address
-- GEORGE A PORTILLA MD
1027 WASHINGTON AVE
DETROIT LAKES, MN 56501-3409
Phone number: 218-847-5611
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