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Individual

LOGAN JACOB MANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
175 HOSPITAL DR, WINCHESTER, KY 40391-9591
(859) 745-3500
Mailing address
5048 PADDOCK LOOP, LAWRENCEBURG, KY 40342-1735
(502) 598-1024

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
01/29/2024
Last updated
06/14/2024
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