Individual
AMANDA LEANNE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 INTERSTATE 20 W, #114, ARLINGTON, TX 76017-5870
(817) 784-8268
(817) 468-9165
Mailing address
PO BOX 120549, ARLINGTON, TX 76012-0549
(817) 303-4521
(817) 459-2856
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
633320
KS
Other
Enumeration date
06/16/2008
Last updated
06/16/2008
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