Provider Demographics
NPI:1922697523
Name:NAVARRO, JUAN FELIPE (DPT)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:FELIPE
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9844 S 1300 E STE 300
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4693
Mailing Address - Country:US
Mailing Address - Phone:801-571-0099
Mailing Address - Fax:
Practice Address - Street 1:1577 W 7000 S STE 100
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-7493
Practice Address - Country:US
Practice Address - Phone:801-566-6301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-322712251X0800X
UT11802753-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist