Individual
MR. MICHAEL KEITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
S.S.W.
Contact information
Practice address
177 PRICE AVE, SALT LAKE CITY, UT 84115-4345
(385) 468-4528
Mailing address
177 PRICE AVE, SALT LAKE CITY, UT 84115-4345
(385) 468-4528
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
7343155-3503
UT
Other
Enumeration date
07/13/2011
Last updated
08/03/2011
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