Provider Demographics
NPI:1750093431
Name:MURPHY, JESSICA ANNE (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 E 6320 S
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-2249
Mailing Address - Country:US
Mailing Address - Phone:208-602-5813
Mailing Address - Fax:
Practice Address - Street 1:6272 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-2126
Practice Address - Country:US
Practice Address - Phone:801-871-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
UT104080562401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist