Individual
CLINT L JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4845 CHUBBUCK AVE, CHUBBUCK, ID 83202
(208) 237-3900
(208) 237-4955
Mailing address
4845 CHUBBUCK AVE, CHUBBUCK, ID 83202
(208) 237-3900
(208) 237-4955
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4731
ID
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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