Individual
RABERTA JO JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
451 E 400 N, PRICE, UT 84501-2626
(435) 262-0216
Mailing address
1600 E 800 N, PRICE, UT 84501-2008
(435) 262-0216
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10476504-4810
UT
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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