Individual
LOGAN SHUTTLEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
21 W CLARKE AVE STE 1500, MILFORD, DE 19963-1857
(302) 491-6529
(302) 503-7160
Mailing address
659 S SALISBURY BLVD STE 1B, SALISBURY, MD 21801-5458
(410) 831-3226
(410) 572-4041
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
U1-0012576
DE
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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