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Individual
LOGAN MCRAE BLANTON
Active
Individual
LOGAN MCRAE BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT60932340
WA
225100000X
Physical Therapist
Primary
PTT32350
FL
Other
Enumeration date
02/19/2017
Last updated
04/12/2021
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