Jensen, Mike

Jensen, Mike is an individual health care provider with primary practice located at 3480 Washington Blvd Ste 107 , Ogden UT 84401-4152. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as his primary health care specialty. Jensen, Mike can be contacted via phone (801) 528-7350.

Contact Information

Primary practice address
3480 Washington Blvd Ste 107 Ogden UT 84401-4152
Phone: (801) 528-7350
Fax: (801) 528-7355
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X

Profile Details

NPI number 1942622527
LBN Legal business name Jensen, Mike
Credentials PRES.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2014
Last updated Jan 15th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942622527 NPPES
Utah Other 13746360 UTAH TAX CERTIFICATE

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