Individual
JUSTIN WALTER LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
1247 E SIENA HEIGHTS DR, ADRIAN, MI 49221-1755
(517) 264-7870
Mailing address
834 NAVARRE ST, MONROE, MI 48161-1348
(734) 552-8862
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001786
MI
Other
Enumeration date
10/07/2017
Last updated
04/20/2023
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