Cailey Mortensen, AUD | |
417 S Wakara Way Ste 1112, Salt Lake City, UT 84108-1448 | |
(801) 581-3506 | |
Not Available |
Full Name | Cailey Mortensen |
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Gender | Female |
Speciality | Audiologist |
Location | 417 S Wakara Way Ste 1112, Salt Lake City, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003590548 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | 11322696-4101 (Utah) | Primary |
Provider Name | University Of Utah Adult Services |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683 |
Mailing Address | Practice Location Address |
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Cailey Mortensen, AUD 417 S Wakara Way Ste 1112, Salt Lake City, UT 84108-1448 Ph: () - | Cailey Mortensen, AUD 417 S Wakara Way Ste 1112, Salt Lake City, UT 84108-1448 Ph: (801) 581-3506 |
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