IndividualActive
Benjamin Johnson
NPI 1366934440 · Athletic Trainer · Moscow, ID
Provider details
- NPI number
- 1366934440
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
875 Perimeter Dr # Ms 2401
Moscow, ID 83844-9803
Phone: (801) 710-0760
Approximate (ZIP-level) locationGet directions
Mailing address
5345 S 4550 W
Hooper, UT 84315-6710
Registry dates
- Enumerated
- 2018-06-04
- Last updated
- 2018-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.