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Individual

RYAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
ASU STATION #10899, SAN ANGELO, TX 76909
(325) 486-6047
Mailing address
850 LUCAS ST APT D, ROCK HILL, SC 29730-4180
(682) 552-0843

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1467
SC
2255A2300X
Athletic Trainer
Primary
AT5557
TX

Other

Enumeration date
11/11/2014
Last updated
01/21/2021
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