Individual
LOGAN ALANE SALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SCAT, ATC
Contact information
Practice address
9200 UNIVERSITY BLVD, NORTH CHARLESTON, SC 29406-9121
(843) 863-7683
Mailing address
9345 BLUE HOUSE RD APT 11301, LADSON, SC 29456-4133
(919) 464-3821
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
SC508088
SC
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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