Individual
MRS. AMY JO LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3525 E HANNA AVE, INDIANAPOLIS, IN 46237-1230
(317) 788-4261
Mailing address
118 MEDICAL DR # 46032, CARMEL, IN 46032-2923
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004052A
IN
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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