Provider Demographics
NPI:1740510460
Name:JOHNSTON, RYAN DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DANIEL
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 SPRING ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-3762
Mailing Address - Country:US
Mailing Address - Phone:501-762-3173
Mailing Address - Fax:
Practice Address - Street 1:2800 SPRING ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-3762
Practice Address - Country:US
Practice Address - Phone:501-767-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor