Healthcare Provider Details

I. General information

NPI: 1952333759
Provider Name (Legal Business Name): JENSEN HEALTH & ENERGY CENTER, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ELM GROVE RD SUITE 325
ELM GROVE WI
53122-2546
US

IV. Provider business mailing address

500 ELM GROVE RD SUITE 325
ELM GROVE WI
53122-2546
US

V. Phone/Fax

Practice location:
  • Phone: 262-782-1616
  • Fax: 262-782-7815
Mailing address:
  • Phone: 262-782-1616
  • Fax: 262-782-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number60-055
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4319-012
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number625-55
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3881-012
License Number StateWI

VIII. Authorized Official

Name: MRS. LAURA L FINSES
Title or Position: OFFICE MANAGER
Credential:
Phone: 262-782-1616