Healthcare Provider Details
I. General information
NPI: 1922697523
Provider Name (Legal Business Name): JUAN FELIPE NAVARRO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/18/2021
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1577 W 7000 S STE 100
WEST JORDAN UT
84084-7493
US
IV. Provider business mailing address
9844 S 1300 E STE 300
SANDY UT
84094-4693
US
V. Phone/Fax
- Phone: 801-566-6301
- Fax:
- Phone: 801-571-0099
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | LPT-32271 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 11802753-2401 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: