SearchIllinois2255A2300X

Logan Brown, ATC, LAT

NPI 1548728116 · on the registry since 2019 · sole proprietor

Practice

Address
2430 W Warner Ave
Chicago, IL 60618
Phone
(502) 648-1164

Additional practice sites

  • 508 Ponder Dr, Shelbyville, KY

Registry record

Primary taxonomy
2255A2300X
2255A2300X
Also registered as
390200000X
Licence states on file
IL, KY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-07-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois