Individual
BRIAN WORTZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4540 E BASELINE RD, 115, MESA, AZ 85206-4613
(480) 306-6405
(480) 361-6108
Mailing address
4540 E BASELINE RD STE 115, MESA, AZ 85206-4617
(480) 306-6405
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3160
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z170907
MEDICARE PTAN
AZ
Enumeration date
02/25/2009
Last updated
11/03/2014
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