Individual
CALLEN LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7365 STEVENTON WAY, JACKSONVILLE, FL 32244-8179
(352) 317-7411
Mailing address
7365 STEVENTON WAY, JACKSONVILLE, FL 32244-8179
(352) 317-7411
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA25366
FL
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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