Individual
MARISSA MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
16816 N MARKETPLACE BLVD, NAMPA, ID 83687-5140
(208) 461-9593
Mailing address
7979 W RIFLEMAN ST STE 200, BOISE, ID 83704-9066
(208) 377-3850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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