Individual
CLARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
258 S MAIN ST STE 210, LOGAN, UT 84321-5768
(435) 383-6120
(435) 557-8003
Mailing address
258 S MAIN ST STE 210, LOGAN, UT 84321-5768
(435) 383-6120
(435) 557-8003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
06226
OR
225100000X
Physical Therapist
19237
MA
225100000X
Physical Therapist
38312
CA
225100000X
Physical Therapist
Primary
8030412-2401
UT
225100000X
Physical Therapist
9307
AZ
Other
Enumeration date
12/12/2011
Last updated
05/09/2023
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