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General NPI Number Information
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NPI Number | 1063182483
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH MCQUEEN LOGAN MS, LAT, ATC, NREMT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 400 MAGNOLIA ST
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City | ORANGEBURG
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State | SC
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Zip | 29115-6815
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Country | US
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Telephone | 215-704-6544
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Fax |
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Provider Business Mailing Address
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Address Line | 400 MAGNOLIA ST
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City | ORANGEBURG
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State | SC
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Zip | 29115-6815
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Country | US
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Telephone | 803-535-5726
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 602665
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1059
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License Number State | SC
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