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Individual
JUSTIN MICHAEL JOHNSON
Active
Individual
JUSTIN MICHAEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10816599-1206
UT
363A00000X
Physician Assistant
Primary
PA-2296
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619362480
—
NV
Enumeration date
03/30/2015
Last updated
08/26/2022
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