Individual
LOGAN ADKISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
815 S WALNUT AVE, COOKEVILLE, TN 38501-5956
(931) 528-5516
Mailing address
302 E CLEVELAND AVE APT B, MONTEREY, TN 38574-1200
(423) 215-1060
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7874
TN
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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