Individual
BLANCHE COLEMAN JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6848 MAHOGANY RD, FAYETTEVILLE, NC 28314-5360
(910) 868-7195
Mailing address
6848 MAHOGANY RD, FAYETTEVILLE, NC 28314-5360
(910) 868-7195
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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