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NPI Code Detail

MEDICARE: JOCELYN BODKIN CONNER DPT

MEDICARE: JOCELYN BODKIN CONNER DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistUT
2225100000XPhysical Therapist
3225100000XPhysical Therapist77382942401UT

General Provider Information

NPI Number : 1720384647
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOCELYN BODKIN CONNER DPT
Provider Business Mailing Address
First Line : 455 E CENTER ST
Second Line :
City : PROVIDENCE
State : UT
Zip : 84332-9641
Country : US
Telephone Number : 540-421-3900
Fax Number :
Provider Business Practice Location Address
First Line : 1480 N 400 E
Second Line :
City : LOGAN
State : UT
Zip : 84341-7525
Country : US
Telephone Number : 435-750-5501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2011
Last Update Date : 10/25/2019

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Directions to “ JOCELYN BODKIN CONNER DPT” Practice Location

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