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Individual

RICHARD J JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1490 E FOREMASTER DR, STE 110, ST GEORGE, UT 84790
(435) 652-4455
(435) 652-4472
Mailing address
PO BOX 428, 1490 E FOREMASTER DR STE 110, ST GEORGE, UT 84790
(435) 652-4455
(435) 652-4472

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5071
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0M0000055827
ALTIUS
01
107008400102
IHC
01
311308
DMBA
01
61582
PEHP
01
87726
UHC
Enumeration date
01/05/2006
Last updated
12/12/2007
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