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General NPI Number Information
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NPI Number | 1992284178
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Entity Type | Individual
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Provider Name | KENDRA JOY JENSEN ATC,
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Gender | Female
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 52ND MEDICAL GROUP SPANGDAHLEM AFB- PHYSICAL THERAPY
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City | SPANGDAHLEM
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State | RHEINLAND-FPLAZ
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Zip | 54529
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Country | DE
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Telephone | 656-561-8330
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 9 BOX 1616
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City | APO
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State | AE
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Zip | 09123-0017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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