Individual
TYLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
(503) 540-6404
Mailing address
28620 N EL MIRAGE RD STE B102, PEORIA, AZ 85383-2098
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
14668
TN
225100000X
Physical Therapist
Primary
65517
OR
225100000X
Physical Therapist
PT014269
GA
Other
Enumeration date
12/10/2019
Last updated
02/17/2025
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