Provider Demographics
NPI:1518942291
Name:ORR, JOHN MICHAEL (DPT, OSC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MICHAEL
Last Name:ORR
Suffix:
Gender:M
Credentials:DPT, OSC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1098 W. SOUTH JORDAN PARKWAY
Mailing Address - Street 2:STE 101
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095
Mailing Address - Country:US
Mailing Address - Phone:801-254-5800
Mailing Address - Fax:801-254-1696
Practice Address - Street 1:1098 W. SOUTH JORDAN PARKWAY
Practice Address - Street 2:STE 101
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095
Practice Address - Country:US
Practice Address - Phone:801-254-5800
Practice Address - Fax:801-254-1696
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT348508-2401225100000X, 208100000X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000079308Medicare UPIN
UT005580814Medicare PIN