Individual
TARA J JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1655 N 200 E, SUITE 2, LOGAN, UT 84341-1945
(435) 753-1844
(435) 753-2986
Mailing address
2380 N 400 E, LOGAN, UT 84341-1749
(435) 713-9710
(435) 753-8005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3617282401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D2434
—
UT
Enumeration date
02/02/2007
Last updated
04/01/2008
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