Individual
LOGAN BRYAN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,LAT,ATC
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(334) 722-0622
Mailing address
103 RICHMOND AVE, TROY, AL 36081-4063
(334) 722-0622
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
326901
LA
Other
Enumeration date
02/06/2019
Last updated
04/23/2024
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