William J Jensen PA-C

NPI 1093805467 - Physician Assistant - 363AM0700X

NPI Details
NPI 1093805467
Gender Male
Enumeration Date 10/13/2006
Last Updated 06/01/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
190 E BANNOCK ST
BOISE ID, 83712-6241, US
Phone (208) 381-2222
Fax
Business Location
100 E IDAHO ST
BOISE ID, 83712-6267, US
Phone (208) 381-9590
Fax (208) 381-9599
Toxanomy
Taxonomy Code 363AM0700X
License State Idaho
License Number PA-618
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According to our database, William J Jensen PA-C NPI is 1093805467, taxonomy code is 363AM0700X and license number is PA-618, license state is located at Idaho. William J Jensen PA-C physically located at 190 E Bannock St, Boise ID, 83712-6241. NPI Number William J Jensen PA-C has the Individual type.

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1093805467 NPI number is provided on an as is basis without warranty of any kind. 1093805467 is maintained by the National Plan & Provider Enumeration System. The contents of William J Jensen PA-C are for informational purposes only.