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1457010019
DEREK J BORTIS
PHOENIX, AZ
NPI
1457010019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
310400000X Assisted Living Facility
Enumeration Date
2021-12-10
Last Update Date
2021-12-10
Business Address
DEREK J BORTIS
2405 W FLORENTINE RD
PHOENIX, AZ 85086-6602
Phone number: 480-826-5087
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Mailing Address
DEREK J BORTIS
26204 N FERNBUSH DR
PHOENIX, AZ 85083-1625
Phone number: 480-826-5087
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