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Individual

MR. HAVEN MICHAEL JOHNSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LOTR

Contact information

Practice address
109 MCCLENDON CHURCH RD, WEST MONROE, LA 71292-8052
(318) 387-3900
Mailing address
747 BROWNLEE RD, CALHOUN, LA 71225-8262
(318) 450-5653

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
329813
LA

Other

Enumeration date
01/12/2022
Last updated
01/14/2022
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