Individual
LOGAN MCCASLEN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1276 VILLAGE WAY APT B, SIDNEY, NE 69162-4045
(308) 249-3480
Mailing address
1276 VILLAGE WAY APT B, SIDNEY, NE 69162-4045
(308) 249-3480
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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