Provider Demographics
NPI:1790011799
Name:MENSINGER, MAGDALENA JIMENEZ (PT)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:JIMENEZ
Last Name:MENSINGER
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 1:273 W 1480 N
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-8994
Mailing Address - Country:US
Mailing Address - Phone:435-882-4381
Mailing Address - Fax:
Practice Address - Street 1:273 W 1480 N
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-8994
Practice Address - Country:US
Practice Address - Phone:435-882-4381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7222848-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist