Healthcare Provider Details

I. General information

NPI: 1487589370
Provider Name (Legal Business Name): JODIE GORNEY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4885 S 900 E STE 204
MURRAY UT
84117-5746
US

IV. Provider business mailing address

2789 W 2935 S
WEST VALLEY CITY UT
84119-1844
US

V. Phone/Fax

Practice location:
  • Phone: 385-831-1204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number6436316-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: