Individual
DR. STACEY MAE MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
108 S MAIN ST, BOX 28, STANLEY, ND 58784
(701) 628-7246
Mailing address
PO BOX 28, STANLEY, ND 58784-0028
(701) 628-7246
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
744
ND
Other
Enumeration date
06/06/2007
Last updated
11/19/2007
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