IndividualActive
Blake Johnson, ATC
NPI 1265824254 · Athletic Trainer · Salt Lake City, UT
Provider details
- NPI number
- 1265824254
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- License
- 6976729-4810 (UT)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone: (801) 587-0757
Approximate (ZIP-level) locationGet directions
Mailing address
1629 W Black Gold Dr
Bluffdale, UT 84065-2386
Registry dates
- Enumerated
- 2015-02-27
- Last updated
- 2015-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.