Individual
ABBY LUCILE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3715 WOODKING DR, IDAHO FALLS, ID 83404-4720
(208) 529-2255
Mailing address
535 MARIAH AVE., APARTMENT 1104, REXBURG, ID 83440
(208) 351-9201
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA-5319
ID
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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