Individual
DR. DIANE MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 PARK AVE, PM&R, MINNEAPOLIS, MN 55415-1623
(585) 319-7732
Mailing address
701 PARK AVE, PM&R, MINNEAPOLIS, MN 55415-1623
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
098993
OH
208100000X
Physical Medicine & Rehabilitation Physician
Primary
57448
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2009
Last updated
12/14/2014
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