Organization
DALE E MORTENSON DC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE E. MORTENSON D.C. (PRESIDENT)
(850) 265-6163
Entity
Organization
Contact information
Practice address
1101 OHIO AVE, LYNN HAVEN, FL 32444-2554
(850) 265-6163
(850) 265-4059
Mailing address
PO BOX 1960, LYNN HAVEN, FL 32444-6960
(850) 265-6163
(850) 265-4059
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH4624
FL
Other
Enumeration date
04/14/2009
Last updated
05/20/2009
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