Individual
RYAN TERRY JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3179 N CANYON RD, PROVO, UT 84604-3916
(801) 377-2002
(801) 377-2007
Mailing address
3638 W 12125 S, RIVERTON, UT 84065-7404
(801) 440-2995
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
336415-1701
UT
Other
Enumeration date
05/01/2007
Last updated
07/28/2022
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