Individual
MS. LAURA L LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CNA
Contact information
Practice address
2307 BELLMORE AVE, BELLMORE, NY 11710-5651
(516) 457-6421
Mailing address
960 WELLWOOD AVE, LINDENHURST, NY 11757-1016
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12888
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8
MASSAGE
—
Enumeration date
09/06/2022
Last updated
09/06/2022
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