Individual
BENJAMIN TODD JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 N 1900 E RM 4C104, SALT LAKE CITY, UT 84132-0002
(801) 581-7606
Mailing address
1355 S 2500 W, SYRACUSE, UT 84075-6941
(801) 589-0475
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
9164133-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/21/2013
Last updated
10/21/2021
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