Shane R Jensen

NPI #1548459068 in Panguitch, Utah

Provider Information

NPI Number: 1548459068
Entity Type: Organization
Organization Name: Shane R Jensen
Primary Specialty: Optometrist
Enumeration Date: Oct 22, 2007
Last Updated: Jun 16, 2008

Practice Location

Address: 415 EAST CENTER STREET
City: Panguitch
State: Utah
ZIP Code: 84759
Phone: (435) 676-8646

Authorized Official

Name: DR. SHANE JENSEN, O.D.
Title: OWNER
Phone: (435) 676-8646

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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DR. Shane Jensen, O.D.	Optometrist	Panguitch	AI Deep Dive
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Organizations

Provider Name	Specialty	City
Southwest Vision, LLC	Optometrist	Panguitch	AI Deep Dive

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