Individual
MELISSA LOGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMF
Contact information
Practice address
9138 CARL LEGETT RD STE C, GULFPORT, MS 39503-6262
(228) 896-3688
(228) 896-3688
Mailing address
9138 CARL LEGETT RD STE C, GULFPORT, MS 39503-6262
(228) 896-3688
(228) 896-3688
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
—
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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