Individual
RYAN ANTHONY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
8731 BURR ST, CROWN POINT, IN 46307-1519
(219) 689-3831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/26/2024
Last updated
12/26/2024
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