Individual
JORDAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
48 N. SHIELDS LANE, MOAD, UT 84532
(435) 259-3155
Mailing address
PO BOX 867, PRICE, UT 84501-0867
(435) 637-7200
(435) 637-2377
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
02/05/2019
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