Healthcare Provider Details

I. General information

NPI: 1154033967
Provider Name (Legal Business Name): GARRETT HARDY JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2022
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3476 W 4600 S
WEST HAVEN UT
84401-9203
US

IV. Provider business mailing address

PO BOX 66
HOOPER UT
84315-0066
US

V. Phone/Fax

Practice location:
  • Phone: 801-689-0200
  • Fax: 801-689-0201
Mailing address:
  • Phone: 801-689-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: