Dr. Ryan J Mortensen
Optometrist
11506 S District Dr Ste 400
South Jordan
, Utah 84095-5769
Dr. Ryan J Mortensen
Optometrist
11506 S District Dr Ste 400
South Jordan
, Utah 84095-5769
(801) 495-4836
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Ryan J Mortensen
- 11506 S District Dr Ste 400
- South Jordan, UT
- Zip : 84095-5769
- Fax : (801) 495-4836
- Phone : (801) 495-4833
Second Address
- Dr. Ryan J Mortensen
- 11506 S District Dr Ste 400
- South Jordan, UT
- Zip : 84095-5769
- Fax : (801) 495-4836
- Phone : (801) 495-4833
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 5898711-9934 | UT |
National Provider Identifier
| NPI | 1003818576 |
|---|---|
| Provider Name | Dr. Ryan J Mortensen |
| First Address | South Jordan, UT 84095-5769 |
| Second Address | South Jordan, UT 84095-5769 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/08/2005 |
| Last Update Date | 07/01/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.