Individual
JORDAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
137 E 3RD AVE APT 14, SALT LAKE CITY, UT 84103-5016
(928) 533-8616
Mailing address
137 E 3RD AVE APT 14, SALT LAKE CITY, UT 84103-5016
(928) 533-8616
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9811570-2401
UT
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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