Individual
LOGAN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1431 PREMIER DR, MANKATO, MN 56001-6076
(507) 386-6600
Mailing address
1431 PREMIER DR, MANKATO, MN 56001-6076
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MN
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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