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NPI Code Detail

MEDICARE: DR. RYAN JOHNSON OTR/L

MEDICARE: DR. RYAN JOHNSON OTR/L
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
1225X00000XOccupational TherapistOT009804OH

General Provider Information

NPI Number : 1174083133
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN JOHNSON OTR/L
Provider Business Mailing Address
First Line : 6165 SHEED RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-3602
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 779 GLENDALE MILFORD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-1161
Country : US
Telephone Number : 513-771-1779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2019
Last Update Date : 03/24/2019

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