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1790091429
MARY ALICE PORTILLO
RICHMOND, VA
NPI
1790091429
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Former Name
MARY ALICE SALUKE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: VA 0618001974)
Enumeration Date
2010-08-18
Last Update Date
2010-08-18
Business Address
-- MARY ALICE PORTILLO O.D.
2400 SHEILA LN
RICHMOND, VA 23225-2040
Phone number: 804-433-1950
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Mailing Address
-- MARY ALICE PORTILLO O.D.
136 IVY DR APT. 12
CHARLOTTESVILLE, VA 22903-5033
Phone number: 937-681-2304
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