Individual
MR. JOHN ROBERT KANGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PR
Contact information
Practice address
1 WASHINGTON AVE, LOGAN, WV 25601-3965
(304) 792-9473
Mailing address
1 WASHINGTON AVE, LOGAN, WV 25601-3965
(304) 792-9473
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
19.918
WV
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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