Provider Demographics
NPI:1871209007
Name:ANDERSON, JOSHUA LOGAN (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:LOGAN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5105
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5100
Mailing Address - Country:US
Mailing Address - Phone:828-698-4318
Mailing Address - Fax:
Practice Address - Street 1:EMERGEORTHO PA
Practice Address - Street 2:800 FLEMING ST
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3528
Practice Address - Country:US
Practice Address - Phone:828-698-4318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15554225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC15554OtherLICENSE