Individual
TYSON REED JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3001 WILDFLOWER DR, 611, BRYAN, TX 77802-3061
(979) 774-4343
Mailing address
3001 WILDFLOWER DR, SUITE 611, COLLEGE STATION, TX 77845-1609
(979) 774-4343
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT105386
TX
Other
Enumeration date
10/29/2009
Last updated
11/09/2009
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