Search › Utah › 172V00000X
Derick Jensen
NPI 1659794402 · on the registry since 2014
Practice
- Address
- 68 S 600 E
Slc, UT 84102 - Phone
- (801) 322-1001
- Fax
- (801) 359-3864
- Organisation at this address
- Odyssey House Of Utah
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 172V00000X
172V00000X
- Sex
- Male
- Record last updated
- 2014-01-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah