Provider Demographics
NPI:1043382708
Name:JARVIS, LOUISE LOKEY (PT MA)
Entity Type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:LOKEY
Last Name:JARVIS
Suffix:
Gender:F
Credentials:PT MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6146 NEW HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121
Mailing Address - Country:US
Mailing Address - Phone:801-979-5825
Mailing Address - Fax:
Practice Address - Street 1:6146 NEW HAVEN DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6527
Practice Address - Country:US
Practice Address - Phone:801-979-5825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1100602401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist