Russell J Jensen, PTA
Individual provider Active NPI Physical Therapy Assistant · Higginsville, MO
NPI 1124389713 · NPPES record last updated Sep 7, 2012
Key facts
- NPI
- 1124389713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 117234 (MO)
- Practice address
- 720 Fairground Ave
Higginsville, MO 64037-1638 - Phone
- (660) 584-7801
- Fax
- (660) 584-8619
- NPI assigned
- May 31, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 117234 | MO | Yes |
Addresses
Primary practice location
720 Fairground Ave
Higginsville, MO 64037-1638
Mailing address
720 Fairground Ave
Higginsville, MO 64037-1638
Phone (660) 584-7801
Other providers in Higginsville, MO
- Sarah Holtcamp
- Katelyn Homfeld
- Blair Hunter
- Rachel Len Huston
- Innate Chiropractic & Wellness Center LLC
- Judi M Kruse
- Lafayette Co C-1 School District
- Lafayette County Board of Sheltered Services
- Lafayette County Board of Sheltered Services
- Carla Looney
All providers in Higginsville, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.