Individual
MR. BRANDON ROSS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT, OTR, LAT, ATC
Contact information
Practice address
1 LOOGOOTEE PLZ, LOOGOOTEE, IN 47553-5757
(812) 709-3286
Mailing address
1701 GRAND AVE, WASHINGTON, IN 47501-1705
(812) 887-7621
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005247A
IN
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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