Doctor Name: | DR. STACEY MAE MORTENSEN |
NPI Number: | 1477756674 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.C. |
License Number: | 744 |
Business Practice Address: | 108 S Main St Box 28 Stanley, ND - 58784 |
Business Phone Number: | 7016287246 |
Business Fax Number: | |
Mailing Address: | Po Box 28, STANLEY |
State: | ND |
Postal Code: | 587840028 |
Phone Number: | 7016287246 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2007 |
NPI Last Update Date: | 11/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |