Individual
MR. BRUCE A MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2000 S THOMPSON ST, FLAGSTAFF, AZ 86001-8759
(928) 226-6400
(928) 226-6410
Mailing address
1110 E ROUTE 66 STE 100, FLAGSTAFF, AZ 86001-4772
(928) 773-9695
(928) 773-0208
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/22/2014
Last updated
10/26/2020
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