OrganizationActive
MD Center for Facial Rejuvenation
NPI 1467520437 · Ophthalmologic Surgery Clinic/Center · Salt Lake City, UT
Provider details
- NPI number
- 1467520437
- Entity type
- Organization
- Primary specialty
- Ophthalmologic Surgery Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Justin Johnsen, Owner
- License
- 6139294-1205 (UT)
Practice location
6440 Wasatch Blvd
Suite 390
Salt Lake City, UT 84121-3511
Phone: (801) 424-3223
Fax: (801) 424-3228
Mailing address
6440 Wasatch Blvd
Salt Lake City, UT 84121-3511
Registry dates
- Enumerated
- 2006-11-30
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.