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Organization
VILLAGE HEALTH LLC
Active
Organization
VILLAGE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK MORTENSEN (OWNER)
(480) 607-9779
Entity
Organization
Contact information
Practice address
14843 N NORTHSIGHT BLVD, SCOTTSDALE, AZ 85260-2629
(480) 607-9779
Mailing address
14843 N NORTHSIGHT BLVD, SCOTTSDALE, AZ 85260-2629
(480) 607-9779
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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