SHAD MORTENSEN

PHOENIX, AZ
NPI1568217644
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-04-22
Last Update Date2024-04-22
Business Address
SHAD MORTENSEN DO
2601 E ROOSEVELT ST
PHOENIX, AZ 85008-4973
Phone number: 435-695-4017
Mailing Address
SHAD MORTENSEN DO
3100 N CENTRAL AVE
PHOENIX, AZ 85012-2637
Phone number:
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