Individual
JORDAN L MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
323 W MONROE STREET, WYOCENA, WI 53969
(608) 429-2181
Mailing address
1924 ATWOOD AVE, #107, MADISON, WI 53704
(715) 571-8482
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13697-24
WI
Other
Enumeration date
06/20/2017
Last updated
03/17/2018
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