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Individual

MRS. PORTLAND E LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1850 SULLIVAN AVE, SUITE 330, DALY CITY, CA 94015-2221
(650) 756-5630
(650) 756-1964
Mailing address
1850 SULLIVAN AVE, SUITE 330, DALY CITY, CA 94015-2221
(650) 756-5630
(650) 756-1964

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
19775
CA

Other

Enumeration date
10/12/2006
Last updated
09/15/2011
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