Healthcare Provider Details

I. General information

NPI: 1427788777
Provider Name (Legal Business Name): SARAH JESSICA GORDON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 S HIGHLAND DR STE 221
SALT LAKE CITY UT
84124-2675
US

IV. Provider business mailing address

4190 S HIGHLAND DR STE 221
SALT LAKE CITY UT
84124-2675
US

V. Phone/Fax

Practice location:
  • Phone: 435-465-0657
  • Fax:
Mailing address:
  • Phone: 435-465-0657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14267595-2401
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number32369
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: