Individual
LOGAN REX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
604 NW 12TH AVE, MIAMI, FL 33136-3610
(305) 326-0003
Mailing address
604 NW 12TH AVE, MIAMI, FL 33136-3610
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4011
FL
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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