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Brock Robert Johanson
Student in an Organized Health Care Education/Training Program in Stansbury Park, Utah
NPI 1982289864

Brock Robert Johanson is a Student in an Organized Health Care Education/Training Program based in Stansbury Park, UT. Brock Robert Johanson practices in Stansbury Park, UT. The NPI Number for Brock Robert Johanson is 1982289864 and holds a License No. (Utah).

The current practice location address for Brock Robert Johanson is 6575 Harvest Ln, Stansbury Park, UT and can be reached out via phone at 208-540-1691.

Location: 6575 Harvest Ln, Stansbury Park, UT, 84074-9063
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982289864
Provider Name
Brock Robert Johanson
Credential
Provider Entity Type
Individual
Gender
Male
Address
6575 Harvest Ln, Stansbury Park, UT, 84074-9063
Phone Number
208-540-1691
Fax Number
Provider Enumeration Date
03/12/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
6575 Harvest Ln
City
Stansbury Park
State
Utah
Zip
84074-9063
Phone Number
208-540-1691
Fax Number
person
Provider Business Mailing Address Details
Address
6575 Harvest Ln
City
Stansbury Park
State
Utah
Zip
84074-9063
Phone Number
208-540-1691
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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