Individual
LOGAN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
565 E SELLERS RD, MARION, SC 29571-6090
(843) 430-0176
Mailing address
565 E SELLERS RD, MARION, SC 29571-6090
(843) 430-0176
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3045
SC
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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