Organization
ALVA HEALTH AND WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY D LOGSDON APRN (LEAD PROVIDER)
(580) 747-0296
Entity
Organization
Contact information
Practice address
515 COLLEGE AVE STE 3, ALVA, OK 73717-2230
(580) 747-0296
Mailing address
515 COLLEGE AVE STE 3, ALVA, OK 73717-2230
(580) 747-0296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200851950A
—
OK
Enumeration date
02/23/2023
Last updated
04/24/2023
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