Provider Demographics
NPI:1700447612
Name:HARPER, JASON LAYNE (DPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:LAYNE
Last Name:HARPER
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 1:792 S 3000 E STE 104
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1801
Mailing Address - Country:US
Mailing Address - Phone:208-431-0211
Mailing Address - Fax:435-355-3759
Practice Address - Street 1:792 S 3000 E STE 104
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1801
Practice Address - Country:US
Practice Address - Phone:208-431-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-23
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-30238225100000X
UT11936802-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist