Doctor Name: | MR. MIKE JENSEN |
NPI Number: | 1942622527 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PRES. |
License Number: | |
Business Practice Address: | 3480 Washington Blvd Ste 107 Ogden, UT - 844014152 |
Business Phone Number: | 8015287350 |
Business Fax Number: | 8015287355 |
Mailing Address: | 3480 Washington Blvd Ste 107, OGDEN |
State: | UT |
Postal Code: | 844014152 |
Phone Number: | 8015287350 |
Fax Number: | 8015287355 |
NPI Enumeration Date: | 01/15/2014 |
NPI Last Update Date: | 01/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |