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1427056860
BLAKE C. MORTENSON
LOGAN, UT
NPI
1427056860
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: UT 48375961205)
Enumeration Date
2005-07-11
Last Update Date
2015-04-20
Business Address
-- BLAKE C. MORTENSON M.D.
1400 N 500 E
LOGAN, UT 84341-2455
Phone number: 435-716-1000
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Mailing Address
-- BLAKE C. MORTENSON M.D.
PO BOX 1108
BOUNTIFUL, UT 84011-1108
Phone number: 801-296-2113
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