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1073339321
ADAM C JENSEEN
CHUBBUCK, ID
NPI
1073339321
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: ID $$$$$$$$$)
Enumeration Date
2024-12-02
Last Update Date
2024-12-02
Business Address
-- ADAM C JENSEEN
5310 DIAMOND CIR
CHUBBUCK, ID 83202-2183
Phone number: 858-264-6361
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Mailing Address
-- ADAM C JENSEEN
5310 DIAMOND CIR
CHUBBUCK, ID 83202-2183
Phone number: 858-264-6361
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