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Individual

JORDAN JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3117 SHORE DR, MARINETTE, WI 54143-4293
(715) 732-5111
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17129
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100320956
WI
Enumeration date
05/22/2023
Last updated
05/06/2025
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