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Individual

TATE ALAN JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
8211 W 3500 S, MAGNA, UT 84044-1851
(801) 250-9638
(801) 250-3204
Mailing address
8211 W 3500 S, MAGNA, UT 84044-1851
(801) 250-9638
(801) 250-3204

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
346683-1206
UT

Other

Enumeration date
07/18/2006
Last updated
07/08/2007
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