Individual
RENEE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
(860) 684-6341
Mailing address
205 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004182
CT
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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