Individual
JOHN LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
709 NORTH DAVIDSON STREET, TULLAHOMA, TN 37388-2346
(931) 434-2484
Mailing address
709 NORTH DAVIDSON STREET, TULLAHOMA, TN 37388-2346
(931) 434-2484
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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