Individual
DR. MARVIN HARRY MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
162 E MAIN ST, MORTENSEN CHIROPRACTIC OFFICE, BRANDON, WI 53919
(920) 346-5286
Mailing address
PO BOX 277, 162 E MAIN ST, BRANDON, WI 53919
(920) 346-5286
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2003012
WI
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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