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1396200119
LOGAN BRYAN COOK
THIBODAUX, LA
NPI
1396200119
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA 326901)
Enumeration Date
2019-02-06
Last Update Date
2024-04-23
Business Address
LOGAN BRYAN COOK MS,LAT,ATC
602 N ACADIA RD
THIBODAUX, LA 70301-4823
Phone number: 334-722-0622
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Mailing Address
LOGAN BRYAN COOK MS,LAT,ATC
103 RICHMOND AVE
TROY, AL 36081-4063
Phone number: 334-722-0622
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