Individual
MR. RYAN DANIEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8362 TAMARACK VILLAGE, RM 108, WOODBURY, MN 55125-3392
(651) 730-9662
Mailing address
8362 TAMARACK VILLAGE, RM 108, WOODBURY, MN 55125-3392
(651) 730-9662
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN-3176
MN
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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