Mortensen, Bartley Brett

Mortensen, Bartley Brett is an individual health care provider with primary practice located at 1055 N 500 W Suite 122, Provo UT 84604-3305. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Mortensen, Bartley Brett can be contacted via phone (801) 429-0610.

Contact Information

Primary practice address
1055 N 500 W Suite 122 Provo UT 84604-3305
Phone: (801) 429-0610
Fax: (801) 429-0629
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 51321992401 Utah

Profile Details

NPI number 1659473361
LBN Legal business name Mortensen, Bartley Brett
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2006
Last updated Jan 11th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659473361 NPPES
Utah Other 827322 DMBA
Utah Other 219420 DMBA
Utah Other 64-00662 DMBA
Utah Other 76205 DMBA
Utah Other P00146137 DMBA
Utah MEDICAID 870281028000 DMBA

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