Individual
TODD JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 SHOUP AVE, IDAHO FALLS, ID 83402-3657
(208) 528-5700
Mailing address
4028 E 600 N, RIGBY, ID 83442-5164
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N39974
ID
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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