Ryan Anthony Johnson

NPI #1578371241 in Peoria, Illinois

Provider Information

NPI Number: 1578371241
Entity Type: Individual
Name: Ryan Anthony Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Dec 26, 2024
Last Updated: Dec 26, 2024

Practice Location

Address: 530 NE GLEN OAK AVE
City: Peoria
State: Illinois
ZIP Code: 61637-0001
Phone: (309) 655-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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