Individual
MADISON RAE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2824 N 66TH AVE # NE68104, OMAHA, NE 68104-3928
(402) 551-2110
Mailing address
2501 N 61ST ST, OMAHA, NE 68104-4017
(402) 686-9689
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1850
NE
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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