Healthcare Provider Details

I. General information

NPI: 1811827785
Provider Name (Legal Business Name): BRAYDEN JAMES JOHNSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 N 1700 W
LAYTON UT
84041-8803
US

IV. Provider business mailing address

3548 S CLEARWATER WAY
SYRACUSE UT
84075-3700
US

V. Phone/Fax

Practice location:
  • Phone: 801-823-0518
  • Fax:
Mailing address:
  • Phone: 801-649-8484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14282009-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: