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Individual

JOHN LOGAN ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 444-2355
Mailing address
5424 PACE DR, PADUCAH, KY 42001-9033

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015580
KY

Other

Enumeration date
12/20/2013
Last updated
12/20/2013
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