Individual
CONNOR LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
395 W COUGAR BLVD, PROVO, UT 84604-3311
(801) 357-7081
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14271190-1206
UT
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
14271190-1206
UT
363AM0700X
Medical Physician Assistant
PA.0009589
CO
Other
Enumeration date
05/20/2024
Last updated
02/24/2026
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