Provider Demographics
NPI:1851940670
Name:NIELSEN, AUSTIN JAY (DPT)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:JAY
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11531 S DISTRICT DR STE 1200
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5782
Mailing Address - Country:US
Mailing Address - Phone:801-260-3100
Mailing Address - Fax:801-260-3101
Practice Address - Street 1:11531 S DISTRICT DR STE 1200
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5782
Practice Address - Country:US
Practice Address - Phone:801-260-3100
Practice Address - Fax:801-260-3101
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251X0800X
TX10395803-24012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic