Individual
LAURIE ANNE JENSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2001 ALFORD PARK DR, KENOSHA, WI 53140-1929
(262) 551-6104
Mailing address
4114 SHEARD RD, KANSASVILLE, WI 53139-9401
(262) 534-9162
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
132-039
WI
Other
Enumeration date
10/07/2005
Last updated
07/08/2007
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