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1306499413
LOGAN SHANE TAYLOR
ATHENS, GA
NPI
1306499413
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-07-17
Last Update Date
2021-07-10
Business Address
LOGAN SHANE TAYLOR ATC
102 CENTER PARK LN
ATHENS, GA 30605-4294
Phone number: 229-375-2426
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Mailing Address
LOGAN SHANE TAYLOR ATC
380 PICCADILLY SQ
ATHENS, GA 30605-3044
Phone number: 229-375-2426
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