Most Relevant Information
Provider Data
| NPI Number: | 1003693128 |
| Provider Name: | NICK JENSEN MS, ATC, CSCS |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/12/2023 |
| Last Updated: | 09/12/2023 |
Provider Practice Location
3805 N 53RD AVE
PHOENIX
AZ
850313046
Practice Location Phone/Fax
| Phone: | 4142026790 |
| Fax: |
Provider Mailing Location
6238 N 30TH PL
PHOENIX
AZ
850162235
Provider Mailing Phone/Fax
| Phone: | 9082461022 |
| Fax: |