Provider Demographics
NPI:1447341607
Name:JEX, JAMES DONALD (PT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DONALD
Last Name:JEX
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5748 CUCHARA WAY
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84065-7294
Mailing Address - Country:US
Mailing Address - Phone:801-815-7782
Mailing Address - Fax:801-254-6671
Practice Address - Street 1:5748 CUCHARA WAY
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84065-7294
Practice Address - Country:US
Practice Address - Phone:801-815-7782
Practice Address - Fax:801-254-6671
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT121238-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist