Individual
MS. LISA MARIE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
309 STATE ROAD 26, MELROSE, FL 32666-3906
(352) 225-1275
Mailing address
PO BOX 482, EARLETON, FL 32631-0482
(352) 225-1275
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
76038
FL
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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