Healthcare Provider Details

I. General information

NPI: 1386555688
Provider Name (Legal Business Name): JORDAN MILLS-KAPELE DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

684 S 1600 W
MAPLETON UT
84664-4486
US

IV. Provider business mailing address

373 W CIMARRON AVE
SARATOGA SPRINGS UT
84045-6423
US

V. Phone/Fax

Practice location:
  • Phone: 801-436-3110
  • Fax:
Mailing address:
  • Phone: 707-761-7098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14283443-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: