Individual
DANIEL O. JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
590 S WAKARA WAY DEPT OF, SALT LAKE CITY, UT 84108-1200
(801) 587-5448
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-5448
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
12817266-1205
UT
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
12817266-1205
UT
Other
Enumeration date
04/12/2017
Last updated
10/27/2023
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