Organization
MD CENTER FOR FACIAL REJUVENATION
Active
Other names
RenewMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN RODNEY JOHNSEN M.D. (OWNER)
(801) 424-3223
Entity
Organization
Contact information
Practice address
6440 WASATCH BLVD, SUITE 390, SALT LAKE CITY, UT 84121-3511
(801) 424-3223
(801) 424-3228
Mailing address
6440 WASATCH BLVD, SUITE 390, SALT LAKE CITY, UT 84121-3511
(801) 424-3223
(801) 424-3228
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
6139294-1205
UT
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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