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Individual

LOGAN SPEICHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
421 N WOODLAND BLVD UNIT 8317, DELAND, FL 32723-8418
(386) 822-7166
Mailing address
421 N WOODLAND BLVD UNIT 8317, DELAND, FL 32723-8418
(386) 822-7166

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4006
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AL4006
ATHLETIC TRAINING
FL
Enumeration date
06/21/2016
Last updated
06/21/2016
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