Individual
ALEXIS M ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
110 W UNIVERSITY DR, MESA, AZ 85201-5818
(480) 668-1917
Mailing address
1600 N ARIZONA AVE APT 1063, CHANDLER, AZ 85225-7197
(480) 291-2090
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
4143
AZ
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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