Individual
SAMANTHA JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPED, CFO
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 232-3241
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
—
—
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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