Healthcare Provider Details

I. General information

NPI: 1700205739
Provider Name (Legal Business Name): JOSHUA DAVID JENSEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 S MAIN ST
ARLINGTON SD
57212-2084
US

IV. Provider business mailing address

PO BOX 302
ARLINGTON SD
57212-0302
US

V. Phone/Fax

Practice location:
  • Phone: 605-983-5131
  • Fax:
Mailing address:
  • Phone: 605-983-5131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1253
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: