Individual
TAMMY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24515 CEDAR SHORES DR, COHASSET, MN 55721-8840
(218) 999-5438
Mailing address
733 N POKEGAMA AVE, GRAND RAPIDS, MN 55744-2649
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101876
MN
Other
Enumeration date
09/13/2010
Last updated
01/21/2015
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