Individual
TYLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
2627 E 2100 S, SALT LAKE CITY, UT 84109-1370
(262) 707-9005
Mailing address
2627 E 2100 S, SALT LAKE CITY, UT 84109-1370
(262) 707-9005
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9068972-4810
UT
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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