Individual
AMBER LEE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
US-491, SHIPROCK, NM 87420
(505) 368-6001
Mailing address
10 PRIMROSE LN, LOS ALAMOS, NM 87544-1588
(505) 412-8617
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6105
NM
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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