Individual
TONY MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2532 W PEORIA AVE, PHOENIX, AZ 85029-4709
(602) 622-1178
Mailing address
2532 W PEORIA AVE, PHOENIX, AZ 85029-4709
(602) 622-1178
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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