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General NPI Number Information
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NPI Number | 1366453821
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Entity Type | Organization
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Legal Business Name | JENSEN DIAGNOSTIC & TREATMENT CENTER
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 13714 GAMMA RD SUITE 125
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City | FARMERS BRANCH
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State | TX
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Zip | 75244-4474
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Country | US
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Telephone | 972-243-5757
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Fax | 972-488-6988
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Provider Business Mailing Address
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Address Line | 13714 GAMMA ROAD SUITE 125
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City | FARMERS BRANCH
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State | TX
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Zip | 75244-4485
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Country | US
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Telephone | 972-243-5757
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Fax | 972-488-6988
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANDRA LEE JENSEN
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Credential | D.C.
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Telephone | 972-243-5757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2952
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License Number State | TX
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