Organization
JENSEN OPTOMETRISTS, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK JENSEN O.D. (OWNER)
(641) 236-7502
Entity
Organization
Contact information
Practice address
935 BROAD ST, GRINNELL, IA 50112-2047
(641) 236-7502
Mailing address
PO BOX 687, GRINNELL, IA 50112-0687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142455
—
IA
Enumeration date
12/27/2006
Last updated
08/23/2011
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