Most Relevant Information
Provider Data
| NPI Number: | 1003414814 |
| Provider Name: | LOGAN MILLER |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/14/2020 |
| Last Updated: | 10/14/2020 |
Provider Practice Location
1111 N KENTUCKY AVE
WEST PLAINS
MO
657752028
Practice Location Phone/Fax
| Phone: | 4172575959 |
| Fax: |
Provider Mailing Location
11004 STATE ROUTE 17
WEST PLAINS
MO
657755861
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |