Individual
TIM LEROY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
2055 N 1450 E, NORTH LOGAN, UT 84341-2086
(435) 363-3732
(888) 668-5207
Mailing address
PO BOX 5, MILLVILLE, UT 84326-0005
(435) 232-4279
(888) 668-5207
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9424731-4201
UT
Other
Enumeration date
02/05/2016
Last updated
08/31/2021
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