MEDICARE: MR. CHRIS C JENSEN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	8487	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477640225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRIS C JENSEN PT

Provider Business Mailing Address
First Line	:	84 HIGHLAND AVE
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-2727
Country	:	US
Telephone Number	:	978-741-0880
Fax Number	:

Provider Business Practice Location Address
First Line	:	84 HIGHLAND AVE
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-2727
Country	:	US
Telephone Number	:	978-741-0880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	03/01/2008

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