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General NPI Number Information
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NPI Number | 1538595764
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Entity Type | Individual
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Provider Name | MARIE FRANKLIN LOGAN
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Gender | Female
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 4778 OVERTON RD
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City | BIRMINGHAM
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State | AL
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Zip | 35210-3803
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Country | US
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Telephone | 205-957-0294
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Fax | 205-957-0298
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Provider Business Mailing Address
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Address Line | 1609 INDIAN SPRINGS LN
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City | BIRMINGHAM
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State | AL
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Zip | 35242-3516
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Country | US
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Telephone | 205-957-0294
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Fax | 205-957-0298
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | APPLIED
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License Number State | AL
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