Individual
LOGAN ANTHONY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
8685 W GRAND RIVER AVE, BRIGHTON, MI 48116-2328
(810) 225-1187
(810) 225-1284
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013587
MI
225XH1200X
Hand Occupational Therapist
0006583
CO
Other
Enumeration date
10/19/2020
Last updated
09/20/2023
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