MEDICARE: DR. ERIC JENSEN D.C.

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	111N00000X	Chiropractor	4312	MN

General Provider Information

NPI Number	:	1639312150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC JENSEN D.C.

Provider Business Mailing Address
First Line	:	7492 W 78TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55439-2513
Country	:	US
Telephone Number	:	952-255-6980
Fax Number	:

Provider Business Practice Location Address
First Line	:	7492 W 78TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55439-2513
Country	:	US
Telephone Number	:	952-255-6980
Fax Number	:

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

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	09/16/2021

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