Individual
TRENTON RYAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 KOONTZ AVE STE 200, CLENDENIN, WV 25045-9581
(304) 548-7272
(304) 542-7149
Mailing address
107 KOONTZ AVE STE 200, CLENDENIN, WV 25045-9581
(304) 548-7272
(304) 542-7149
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2508
WV
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/26/2020
Last updated
02/26/2022
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