Individual
DR. SPENCER DAVID MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D, F.A.A.O.
Contact information
Practice address
462 E 100 S, SALT LAKE CITY, UT 84111-1802
(801) 532-5176
(801) 532-5179
Mailing address
462 E 100 S, SALT LAKE CITY, UT 84111-1802
(801) 532-5176
(801) 532-5179
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
109072-9934
UT
Other
Enumeration date
12/12/2006
Last updated
11/08/2021
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