Individual
LOGAN HAUSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
199 FRONTIER TRL, POCAHONTAS, AR 72455-1379
(870) 926-9076
Mailing address
199 FRONTIER TRL, POCAHONTAS, AR 72455-1379
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
OT-A1192
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217966721
—
AR
Enumeration date
03/06/2017
Last updated
03/13/2017
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