Provider Demographics
NPI:1003658618
Name:JOENS, PARKER (PT, DPT, CSCS)
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:
Last Name:JOENS
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 STADIUM WAY DEPT 2701
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84408-2701
Mailing Address - Country:US
Mailing Address - Phone:801-626-7712
Mailing Address - Fax:801-626-7264
Practice Address - Street 1:3870 STADIUM WAY DEPT 2701
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84408-2701
Practice Address - Country:US
Practice Address - Phone:801-626-7712
Practice Address - Fax:801-626-7264
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD60692251S0007X
UT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports