Individual
LOGAN STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2325 210TH ST, MOUNT AYR, IA 50854-8891
(386) 507-5449
Mailing address
2325 210TH ST, MOUNT AYR, IA 50854-8891
(386) 507-5449
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND8320
FL
Other
Enumeration date
09/08/2022
Last updated
04/20/2026
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