Individual
MR. ANTHONY WILLIAM JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1094 S BLAIR ST, SALT LAKE CITY, UT 84111-4703
(702) 885-6791
Mailing address
1094 S BLAIR ST, SALT LAKE CITY, UT 84111-4703
(702) 885-6791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
366543-1206
UT
363A00000X
Physician Assistant
PA158656
OR
Other
Enumeration date
09/05/2012
Last updated
02/13/2013
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