Provider Demographics
NPI:1992284178
Name:JENSEN, KENDRA JOY (ATC,)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:JOY
Last Name:JENSEN
Suffix:
Gender:F
Credentials:ATC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 9 BOX 1616
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09123-0017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52ND MEDICAL GROUP SPANGDAHLEM AFB- PHYSICAL THERAPY
Practice Address - Street 2:
Practice Address - City:SPANGDAHLEM
Practice Address - State:RHEINLAND-FPLAZ
Practice Address - Zip Code:54529
Practice Address - Country:DE
Practice Address - Phone:656-561-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer