BLAKE JOHNSON

SALT LAKE CITY, UT
NPI1265824254
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: UT  6976729-4810)
Enumeration Date2015-02-27
Last Update Date2015-02-27
Business Address
-- BLAKE JOHNSON ATC
590 S WAKARA WAY
SALT LAKE CITY, UT 84108-1200
Phone number: 801-587-0757
Mailing Address
-- BLAKE JOHNSON ATC
1629 W BLACK GOLD DR
BLUFFDALE, UT 84065-2386
Phone number:
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