Individual
BYRON KENT JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
137 W MAIN ST, TREMONTON, UT 84337-1629
(435) 279-4980
(435) 921-0801
Mailing address
137 W MAIN ST, TREMONTON, UT 84337-1629
(435) 279-4980
(435) 921-0801
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
9-723180-0
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9-723180-0
—
UT
Enumeration date
07/22/2016
Last updated
07/22/2016
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