Individual
LOGAN STODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22625 SANDY LN, PORTER, TX 77365-5594
(936) 615-2038
Mailing address
22625 SANDY LN, PORTER, TX 77365-5594
(936) 615-2038
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT9413
TX
Other
Enumeration date
04/10/2022
Last updated
10/02/2023
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