Misti Mortensen

NPI #1902250889 in Muse, Oklahoma

Provider Information

NPI Number: 1902250889
Entity Type: Individual
Name: Misti Mortensen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Apr 18, 2016
Last Updated: Apr 18, 2016

Practice Location

Address: 26652 MUSE ROAD
City: Muse
State: Oklahoma
ZIP Code: 74949
Phone: (435) 790-2159

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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