Provider Demographics
NPI:1154370427
Name:JENSEN, GREGORY A (MS, ATC, EMT-B)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:JENSEN
Suffix:
Gender:M
Credentials:MS, ATC, EMT-B
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:1655 TABEGUACHE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7238
Mailing Address - Country:US
Mailing Address - Phone:970-290-1717
Mailing Address - Fax:
Practice Address - Street 1:141 MOBY ARENA
Practice Address - Street 2:COLORADO STATE UNIVERSITY
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-1887
Practice Address - Country:US
Practice Address - Phone:970-290-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer