Individual
MARK JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2829
Mailing address
5124 S OPAL RD, FLAGSTAFF, AZ 86005-6808
(928) 814-8933
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S016875
AZ
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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