Individual
MR. GLEN ERIC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3940 WEST 4100 SOUTH, WEST VALLEY CITY, UT 84120
(801) 966-3700
(801) 966-9421
Mailing address
555 E 4500 S, C-150, SALT LAKE CITY, UT 84107-4533
(801) 288-0747
(801) 288-0761
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1547641205
UT
Other
Enumeration date
08/30/2006
Last updated
01/05/2011
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