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Individual

NYLIN J JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1188 SPORTSPLEX DR, KAYSVILLE, UT 84037-9591
(801) 547-1155
(801) 547-1173
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171
(801) 942-3311
(801) 942-5955

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1184062401
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
N0793
UT
Enumeration date
09/07/2006
Last updated
12/24/2007
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