Provider Demographics
NPI:1902390123
Name:HARPER, ANDREA MARIE HENDRICKS (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE HENDRICKS
Last Name:HARPER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5263 W SUN BLOOM CIR
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6649
Mailing Address - Country:US
Mailing Address - Phone:801-664-1698
Mailing Address - Fax:
Practice Address - Street 1:98 N 1100 E STE 402
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2951
Practice Address - Country:US
Practice Address - Phone:801-492-2405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic