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NPI Code Detail

MEDICARE: RYAN JOHNSON

MEDICARE: RYAN JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistLPT-033346AZ

General Provider Information

NPI Number : 1104459353
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN JOHNSON
Provider Business Mailing Address
First Line : PO BOX 80217
Second Line :
City : PHOENIX
State : AZ
Zip : 85060-0217
Country : US
Telephone Number : 602-385-2115
Fax Number : 480-418-3323
Provider Business Practice Location Address
First Line : 9219 E HIDDEN SPUR TRL STE 100
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-6708
Country : US
Telephone Number : 602-648-5444
Fax Number : 602-772-3801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2020
Last Update Date : 03/17/2026

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Directions to “ RYAN JOHNSON ” Practice Location

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