Individual
LOGAN ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 UNIVERSITY PKWY # N, HIGH POINT, NC 27268-0002
(336) 841-4636
Mailing address
301 MASTER DERBY DR, HAVRE DE GRACE, MD 21078-2359
(443) 875-0779
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2026
Last updated
06/18/2026
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