Individual
LOGAN ARIC TKACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
36475 FIVE MILE RD, LIVONIA, MI 48154-1971
(313) 318-2403
Mailing address
9885 MANOR AVE, ALLEN PARK, MI 48101-1344
(313) 318-2403
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
462889
MI
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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