Individual
DR. GREGORY LEE MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
108 MAIN ST, 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
722
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12245
—
ND
Enumeration date
03/20/2007
Last updated
04/29/2014
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