Individual
LOGAN WILLHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001
(507) 625-4031
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
225X00000X
Occupational Therapist
Primary
106014
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/11/2016
Last updated
09/18/2020
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