Individual
MR. LOGAN NAGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
1815 WELLS ST, LAS CRUCES, NM 88003-1304
(575) 646-7574
Mailing address
142 BEATRICE LN, CHILLICOTHE, OH 45601-7834
(567) 224-5447
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
572
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000012918
BOARD OF CERTIFICATION OF ATHLETIC TRAINING
OH
01
—
572
STATE OF NEW MEXICO REGULATIONS & LICENSING DEPARTMENT ATHLETIC TRAINERS PRACTIC
NM
Enumeration date
04/06/2015
Last updated
04/06/2015
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