Most Relevant Information
Provider Data
| NPI Number: | 1003015579 |
| Provider Name: | TINA MARIE JENSEN PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 041-0000318 |
Most Important Dates
| Enumeration Date: | 07/15/2007 |
| Last Updated: | 07/15/2007 |
Provider Practice Location
9 HAYWOOD AVE
RUTLAND
VT
057014832
Practice Location Phone/Fax
| Phone: | 8027476433 |
| Fax: |
Provider Mailing Location
215 PARKER RD
EAST WALLINGFORD
VT
057429690
Provider Mailing Phone/Fax
| Phone: | 8022592192 |
| Fax: |