| NPI | 1669756227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J JENSEN Owner 772-345-3933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME105483) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2011-09-30 |