Individual
LOGAN JONATHAN POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1311 WAKARUSA DRIVE, LAWRENCE KS SUITE 1000, SUITE 1000, LAWRENCE, KS 66049-6604
(785) 749-1300
(785) 749-4746
Mailing address
1311 WAKARUSA DRIVE, LAWRENCE KS, SUITE 1000, LAWRENCE, KS 66049
(785) 749-1300
(785) 749-4746
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14-04021
KS
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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