Provider Demographics
NPI:1578042453
Name:JENSEN, MARGARET SUE (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:SUE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-4801
Mailing Address - Country:US
Mailing Address - Phone:406-782-5887
Mailing Address - Fax:406-782-8772
Practice Address - Street 1:1309 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4801
Practice Address - Country:US
Practice Address - Phone:406-782-5887
Practice Address - Fax:406-782-8772
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PTA-LIC-1217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist