Mortensen, Todd Philip
Mortensen, Todd Philip is an individual health care provider with primary practice located at 422 N Wisconsin St Ste A , Elkhorn WI 53121-1318. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Mortensen, Todd Philip can be contacted via phone (262) 723-3235.Contact Information
Primary practice address
422 N Wisconsin St Ste A
Elkhorn WI 53121-1318
Phone: (262) 723-3235
Fax: (262) 723-8621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 3859-012 | Wisconsin |
| Chiropractic Providers / Chiropractor | 111N00000X | 4229 | Minnesota |
| Chiropractic Providers / Chiropractor | 111N00000X | 38010724 | Illinois |
Profile Details
| NPI number | 1437200714 |
|---|---|
| LBN Legal business name | Mortensen, Todd Philip |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Feb 7th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437200714 | NPPES |
| Wisconsin | MEDICAID | 38943900 | |
| Wisconsin | MEDICAID | 39004100 |
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