Individual
BEAU LOGAN MASSINGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1291 N TELEGRAPH RD, MONROE, MI 48162-3368
(734) 243-0300
(734) 243-3066
Mailing address
510 E 3RD ST, MONROE, MI 48161-2004
(734) 625-6903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501302274
MI
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
01/09/2019
Last updated
10/12/2022
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