Individual
LOGAN DAVID DEHAMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1590 WILLOW CREEK RD, PRESCOTT, AZ 86301-1164
(928) 227-1899
Mailing address
4245 W THUNDER MOUNTAIN RD, CHINO VALLEY, AZ 86323-8155
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-28584
AZ
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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