| NPI | 1528045010 |
|---|---|
| Former Name | PHONDA KAY JENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 1866) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 102) |
| 225100000X Physical Therapist (Licence: UT 741064032401) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2011-02-01 |