Individual
LOGAN JERALD DEWHITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3317 N WIMBERLY DR FL 2, FAYETTEVILLE, AR 72703-4056
(795) 873-1174
Mailing address
3317 N WIMBERLY DR FL 2, FAYETTEVILLE, AR 72703-4056
(795) 873-1174
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4706
AR
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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