Provider Demographics
NPI:1225668346
Name:VAN HEMERT, JENNA ROSE (PT, DPT, NCS)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:ROSE
Last Name:VAN HEMERT
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10619 S JORDAN GTWY STE 205
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-3969
Mailing Address - Country:US
Mailing Address - Phone:801-264-0213
Mailing Address - Fax:801-264-0219
Practice Address - Street 1:10619 S JORDAN GTWY STE 205
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-3969
Practice Address - Country:US
Practice Address - Phone:801-264-0213
Practice Address - Fax:801-264-0219
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14189949-2401225100000X
COPTL.0015345225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist