Individual
DR. CHAD RYAN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 N WASHINGTON BLVD, NORTH OGDEN, UT 84414-7233
(801) 786-7500
(801) 737-9531
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 779-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
62664731205
UT
Other
Enumeration date
08/30/2006
Last updated
07/01/2008
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