Individual
JAKE C JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4204 CORAL PARK DR, BRUNSWICK, GA 31520-3016
(912) 280-9205
(912) 280-0022
Mailing address
3100 OLYMPUS BLVD STE 500, COPPELL, TX 75019-5473
(866) 221-5405
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014005
GA
Other
Enumeration date
06/13/2019
Last updated
04/15/2021
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