Individual
LOGAN JAMES WILBERDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
470 GARFIELD AVE, EVANSVILLE, WI 53536-1099
(608) 882-6559
Mailing address
1010 E WASHINGTON AVE APT 410, MADISON, WI 53703-4413
(954) 778-7529
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7115-27
WI
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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