Individual
MR. JEREMY ALTON JENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
633 S 550 E, PROVO, UT 84606-5556
(801) 687-1357
Mailing address
633 S 550 E, PROVO, UT 84606-5556
(801) 687-1357
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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