NPI 1821393745

Jessica Petersen, PTA

Practitioner Physical Therapy Assistant Sandy, UT

Practice location

Address: 8550 S 300 E APT 3, Sandy, UT 84070-1676
Phone: (307) 679-0532

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 7852051-2402 (UT)

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Registry record

NPI: 1821393745
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Jan 2011
Record last updated: 25 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.