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Individual

ALYSSA HITCH JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.AC

Contact information

Practice address
971 MOUNTAIN WILLOW LN, PARK CITY, UT 84098-4610
(828) 699-4832
Mailing address
971 MOUNTAIN WILLOW LANE, PARK CITY, UT 84098
(828) 699-4832

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
8453211-1201
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8453211-1201
UTAH ACUPUNCTURE LICENSE NUMBER
UT
Enumeration date
12/10/2012
Last updated
12/10/2012
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