Individual
MRS. SANDY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7109
Mailing address
PO BOX 413067, SALT LAKE CITY, UT 84141-3067
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3102028-1206
UT
Other
Enumeration date
09/14/2011
Last updated
01/25/2022
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