Organization
ASCEND2LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON G MORTENSEN M.S. QMRP (DIRECTOR)
(435) 660-9446
Entity
Organization
Contact information
Practice address
1367 N 550 E, NEPHI, UT 84648-2213
(435) 660-9446
Mailing address
1367 N 550 E, NEPHI, UT 84648-2213
(435) 660-9446
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
6354409-0160
UT
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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