Provider Demographics
NPI:1790744613
Name:KNIGHTON, JULIE MOTTA (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MOTTA
Last Name:KNIGHTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5728 S 1475 E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4833
Mailing Address - Country:US
Mailing Address - Phone:801-479-4471
Mailing Address - Fax:
Practice Address - Street 1:5728 S 1475 E
Practice Address - Street 2:SUITE 102
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4833
Practice Address - Country:US
Practice Address - Phone:801-479-4471
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT114257-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist