Individual
MIKELL JO JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
960 N DIXIE DOWNS RD, ST GEORGE, UT 84770-4206
(435) 628-0612
Mailing address
474 W 200 N, SUITE 200, ST GEORGE, UT 84770-4505
(435) 628-0612
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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