Individual
DIANE CLARY JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4630 GATESIDE LN SE, MARIETTA, GA 30067-4087
(770) 984-0949
Mailing address
68 GLOBAL DR, SUITE 100, GREENVILLE, SC 29607-4628
(864) 644-2700
(864) 644-2709
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
027978
GA
Other
Enumeration date
06/27/2006
Last updated
10/29/2010
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