Individual
LOGAN TAYLOR RUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
251 S CLARK ST, MILLEDGEVILLE, GA 31061
(478) 445-1787
Mailing address
115 HIGHGREEN RDG, PEACHTREE CITY, GA 30269-2259
(404) 734-8990
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003394
GA
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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