Individual
RYAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3445 BOONE RD SE, SALEM, OR 97317-9336
(503) 576-3000
Mailing address
4075 AERIAL WAY APT 49, EUGENE, OR 97402-8730
(541) 908-5768
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09531
OR
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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