Individual
MARTIN OLEEN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
119 E ARCADIA AVE BLDG 622, 27 SPECIAL OPERATIONS SUPPORT SQDN/OSM, CANNON AFB, NM 88103-5112
(575) 784-0287
Mailing address
119 E ARCADIA AVE BLDG 622, 27 SPECIAL OPERATIONS SUPPORT SQDN/OSM, CANNON AFB, NM 88103-5112
(575) 784-0287
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
04/28/2009
Last updated
04/28/2009
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