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Individual

LOGAN ARDEN KANODE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT, CWC

Contact information

Practice address
1609 N PRINCE ST, CLOVIS, NM 88101-4850
(505) 454-1213
(505) 425-2798
Mailing address
1609 N PRINCE ST, CLOVIS, NM 88101-4850
(575) 935-0360
(575) 935-0361

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4234
NM
225100000X
Physical Therapist
PT4234
NM

Other

Enumeration date
11/15/2012
Last updated
10/29/2020
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