Individual
MATTHEW TRENT JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
652 S. MEDICAL CENTER DR. #LL10, ST. GEORGE, UT 84790-7017
(435) 251-2250
Mailing address
652 S. MEDICAL CENTER DR. #LL10, ST. GEORGE, UT 84790-7017
(435) 251-2250
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
313728-2401
UT
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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