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1407472517
LOGAN RUSSELL
ROANOKE, VA
NPI
1407472517
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: VA 2305207787)
Enumeration Date
2020-06-24
Last Update Date
2020-06-24
Business Address
LOGAN RUSSELL PT, DPT
3656 PETERS CREEK ROAD EXT SW # B
ROANOKE, VA 24018-1512
Phone number: 540-798-1579
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Mailing Address
LOGAN RUSSELL PT, DPT
3656 PETERS CREEK ROAD EXT SW # B
ROANOKE, VA 24018-1512
Phone number:
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