Organization
RYAN J. MORTENSEN, INC
Active
Other names
District Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN MORTENSEN O.D. (DOCTOR)
(801) 495-4833
Entity
Organization
Contact information
Practice address
11506 S DISTRICT DR STE 400, SOUTH JORDAN, UT 84095-5769
(801) 495-4833
Mailing address
11506 S DISTRICT DR STE 400, SOUTH JORDAN, UT 84095-5769
(801) 495-4833
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5898711-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528496527001
—
UT
Enumeration date
01/25/2016
Last updated
01/25/2016
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