Healthcare Provider Details

I. General information

NPI: 1245424985
Provider Name (Legal Business Name): LINDSAY JEAN ROPER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY JEAN JACOBSEN DPT

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S 200 E
SLC UT
84111-3835
US

IV. Provider business mailing address

660 S 200 E
SLC UT
84111-3835
US

V. Phone/Fax

Practice location:
  • Phone: 801-359-2256
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT33915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: