Individual
LENNARD CARL JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
144 S 500 E, EPIC, SALT LAKE CITY, UT 84102-1907
(801) 463-7415
Mailing address
144 S 500 E, EPIC, SALT LAKE CITY, UT 84102-1907
(602) 515-2411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
8191802-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2009
Last updated
07/30/2012
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