Individual
DEREK J BORTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2405 W FLORENTINE RD, PHOENIX, AZ 85086-6602
(480) 826-5087
Mailing address
26204 N FERNBUSH DR, PHOENIX, AZ 85083-1625
(480) 826-5087
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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