Healthcare Provider Details

I. General information

NPI: 1043175664
Provider Name (Legal Business Name): KATIE LYNN HARRIS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4587 W CEDAR HILLS DR STE 110
CEDAR HILLS UT
84062-8827
US

IV. Provider business mailing address

748 N 480 W
OREM UT
84057-5710
US

V. Phone/Fax

Practice location:
  • Phone: 801-406-6943
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: