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1104211101
LOGAN NAGEL
LAS CRUCES, NM
NPI
1104211101
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NM 572)
Enumeration Date
2015-04-06
Last Update Date
2015-04-06
Business Address
Mr. LOGAN NAGEL ATC/L
1815 WELLS ST
LAS CRUCES, NM 88003-1304
Phone number: 575-646-7574
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Mailing Address
Mr. LOGAN NAGEL ATC/L
142 BEATRICE LN
CHILLICOTHE, OH 45601-7834
Phone number: 567-224-5447
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