Andrew Ryan Johnson, DC | |
3900 Vinewood Ln N Ste 19, Plymouth, MN 55441-1155 | |
(763) 559-9236 | |
Not Available |
Full Name | Andrew Ryan Johnson |
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Gender | Male |
Speciality | Chiropractor |
Location | 3900 Vinewood Ln N Ste 19, Plymouth, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770296097 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 7061 (Minnesota) | Primary |
Provider Name | Plymouth Chirocenter Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1063013340 PECOS PAC ID: 9436562824 Enrollment ID: O20201231001813 |
Mailing Address | Practice Location Address |
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Andrew Ryan Johnson, DC 3900 Vinewood Ln N Ste 19, Plymouth, MN 55441-1155 Ph: (763) 559-9236 | Andrew Ryan Johnson, DC 3900 Vinewood Ln N Ste 19, Plymouth, MN 55441-1155 Ph: (763) 559-9236 |
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