Individual
JOSEPH SIOJO TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2060 HEALTH DR SW, WYOMING, MI 49519-9687
(616) 333-1200
Mailing address
82 CAMPAU CIR NW, GRAND RAPIDS, MI 49503-2659
(248) 930-6581
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009733
MI
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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