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Individual

JOHN A MORTENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2255 S 108TH ST, WEST ALLIS, WI 53227-1107
(414) 774-4200
(414) 774-6828
Mailing address
2255 S 108TH ST, WEST ALLIS, WI 53227-1107
(414) 774-4200
(414) 774-6828

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
365-156
WI

Other

Enumeration date
05/26/2006
Last updated
05/23/2014
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