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1629333554
SUZANNE E LOGAN
DECATUR, IL
NPI
1629333554
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160002521)
Enumeration Date
2012-07-06
Last Update Date
2012-07-06
Business Address
Mrs. SUZANNE E LOGAN PTA
2300 N EDWARD ST
DECATUR, IL 62526-4163
Phone number: 217-876-2690
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Mailing Address
Mrs. SUZANNE E LOGAN PTA
2300 N EDWARD ST
DECATUR, IL 62526-4163
Phone number:
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