LOGAN PLUCKEBAUM

BOISE, ID
NPI1649158718
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy222Q00000X Developmental Therapist
Enumeration Date2025-08-26
Last Update Date2025-08-26
Business Address
LOGAN PLUCKEBAUM IP
7557 W USTICK RD
BOISE, ID 83704-5810
Phone number: 208-890-4405
Mailing Address
LOGAN PLUCKEBAUM IP
443 E HEARTHSTONE DR
BOISE, ID 83702-1727
Phone number: 208-890-4405
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