Individual
JOHN MITCHELL TANJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
3350 BROADMOOR AVENUE SE, GRAND RAPIDS, MI 49512
(616) 391-7792
(616) 391-7799
Mailing address
3350 BROADMOOR AVE SE, GRAND RAPIDS, MI 49512-2867
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201003810
MI
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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