Organization
DR TERRI MORTENSEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRI MORTENSEN (OWNER)
(954) 417-6545
Entity
Organization
Contact information
Practice address
4900 S UNIVERSITY DR, STE 200 D, DAVIE, FL 33328-3808
(954) 417-6545
Mailing address
4900 S UNIVERSITY DR, STE 200 D, DAVIE, FL 33328-3808
(954) 417-6545
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PY7594
FL
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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