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Individual
BARTLEY BRETT MORTENSEN
Active
Individual
BARTLEY BRETT MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
51321992401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
219420
ALTIUS
UT
01
—
64-00662
UNITED HEALTHCARE
UT
01
—
76205
PEHP
UT
01
—
827322
DMBA
UT
05
—
870281028000
—
UT
01
—
P00146137
PALMETTO
UT
Enumeration date
09/02/2006
Last updated
01/11/2010
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