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General NPI Number Information
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NPI Number | 1437558590
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Entity Type | Individual
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Provider Name | LOGAN DAVID POST ATC
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Gender | Male
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 3588 BRYAN
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City | IRVINE
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State | CA
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Zip | 92602-1347
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Country | US
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Telephone | 714-734-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 11 SAGEBRUSH
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City | COTO DE CAZA
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State | CA
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Zip | 92679-5326
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Country | US
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Telephone | 949-887-9165
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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