Lisa Marie Logan, LMT
Massage Therapist in Melrose, FL. Individual provider (NPI-1).
NPI number1548096969
StatusActive
Last updated in NPPESSep 11, 2024
Details
- NPI
- 1548096969
- Entity type
- Individual (NPI-1)
- Name
- Ms. Lisa Marie Logan
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 11, 2024
- Certification date
- Sep 11, 2024
- Last updated
- Sep 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 76038 | FL | Yes |
Practice location
309 State Road 26Melrose, FL 32666-3906
Phone 352-225-1275
Mailing address
Po Box 482Earleton, FL 32631-0482
Phone 352-225-1275
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