Individual
JON BURKE JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
76544502401
UT
225100000X
Physical Therapist
9255
AZ
Other
Enumeration date
01/05/2011
Last updated
05/27/2015
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