Individual
JODIE J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2364 W 12600 S, SUITE E, RIVERTON, UT 84065-7109
(801) 446-7600
(801) 446-0912
Mailing address
2364 W 12600 S, SUITE E, RIVERTON, UT 84065-7109
(801) 446-7600
(801) 446-0912
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
963300949934
UT
152WC0802X
Corneal and Contact Management Optometrist
330094-9934
UT
152WL0500X
Low Vision Rehabilitation Optometrist
3300949934
UT
152WP0200X
Pediatric Optometrist
330094-9934
UT
152WS0006X
Sports Vision Optometrist
330094-9934
UT
152WV0400X
Vision Therapy Optometrist
330094-9934
UT
152WX0102X
Occupational Vision Optometrist
Primary
330094-9934
UT
Other
Enumeration date
07/07/2006
Last updated
09/11/2025
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