Individual
DR. RYAN MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1300 FRANKLIN AVE STE 110, NORMAL, IL 61761-3799
(309) 268-3502
Mailing address
2000 N LINDEN ST APT C305, NORMAL, IL 61761-5337
(740) 632-3117
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
125069500
IL
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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