Organization
JASON JORGENSEN, DO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN VAWTER (ADMINISTRATOR)
(801) 388-7745
Entity
Organization
Contact information
Practice address
500 W MAIN ST, LEWISVILLE, TX 75057-3641
(214) 970-6817
(682) 593-0695
Mailing address
2637 N WASHINGTON BLVD # 164, NORTH OGDEN, UT 84414-2240
(801) 388-7745
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
N9717
TX
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
06/13/2013
Last updated
02/22/2021
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