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Individual

DAVID NATHAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, ECS

Contact information

Practice address
52 N 1100 E, AMERICAN FORK, UT 84003-2952
(801) 465-6911
Mailing address
PO BOX 1803, OREM, UT 84059-1803
(801) 367-5204

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
367745-2401
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
198045
ALTIUS PROVIER NUMBER
UT
Enumeration date
04/30/2007
Last updated
07/08/2007
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