Provider Demographics
NPI:1467171470
Name:HARRIS-PHILLIPS, JODI BELLE (MSPT, DPT)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:BELLE
Last Name:HARRIS-PHILLIPS
Suffix:
Gender:F
Credentials:MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 N 1100 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2917
Mailing Address - Country:US
Mailing Address - Phone:801-310-6771
Mailing Address - Fax:
Practice Address - Street 1:169 N 1100 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2917
Practice Address - Country:US
Practice Address - Phone:801-310-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT275126-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist