Mortensen, Shad

Mortensen, Shad is an individual health care provider with primary practice located at 2601 E Roosevelt St , Phoenix AZ 85008-4973. He recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as his primary health care specialty. Mortensen, Shad can be contacted via phone (435) 695-4017.

Contact Information

Primary practice address
2601 E Roosevelt St Phoenix AZ 85008-4973
Phone: (435) 695-4017
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1568217644
LBN Legal business name Mortensen, Shad
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2024
Last updated Apr 22nd, 2024 - about 2 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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