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1548281884
FRED R JENSEN
PROVIDENCE, RI
NPI
1548281884
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: RI PTA00421)
Enumeration Date
2006-07-22
Last Update Date
2007-07-08
Business Address
Mr. FRED R JENSEN PTA
830 CHALKSTONE AVE
PROVIDENCE, RI 02908-4734
Phone number: 401-273-7100
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Mailing Address
Mr. FRED R JENSEN PTA
43 HAWTHORNE ST
NORTH PROVIDENCE, RI 02904-3816
Phone number:
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