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Individual

LOGAN PRESCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3545 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 269-3282
Mailing address
5650 E FARM ROAD 132, SPRINGFIELD, MO 65802-9494
(417) 880-2865

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2018029949
MO

Other

Enumeration date
08/04/2019
Last updated
08/04/2019
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