Eliza Gunn Clark, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14032 Issued in CT

Practice address

98 N 1100 E Ste 402
American Fork, UT 84003-2951

Phone

(801) 492-2405

NPI assigned

Jan 7, 2022

Last updated

Aug 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Eliza Gunn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1376204636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 E 900 N APT 106",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846062105",
            "telephone_number": "412-716-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 N 1100 E STE 402",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032951",
            "telephone_number": "801-492-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELIZA",
        "middle_name": "GUNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2023-08-10",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12615494-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZA",
            "last_name": "GUNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph D Christensen, DMD, MS
• Spencer E Christensen, PT
• Tanner Christenson
• Naomi Lund Christiansen, CSW
• Daniel Avery Clark //1970
• Emily Ann Clark, LMT
• Ethan Clark
• Hunter Barry Clark, DC
• James L Clark, MD
• Jay Austin Clark, M.D.

• Physical Therapist in American Fork, UT
• Providers in American Fork, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.