Individual
DANIEL NATHAN JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1358 W BUSINESS PARK DR, OREM, UT 84058-2203
(801) 373-1197
Mailing address
662 E 1500 S, OREM, UT 84097-7747
(801) 808-8603
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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