Individual
MR. RYAN SCOTT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
10 NORTH VIRGINIA STREET, CRYSTAL LAKE, IL 60014
(815) 459-3860
Mailing address
10 NORTH VIRGINIA STREET, CRYSTAL LAKE, IL 60014
(815) 459-3860
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227004563
IL
Other
Enumeration date
08/05/2014
Last updated
08/06/2014
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