Individual
LOGAN LEWIS GEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2505 MASON DR, SHAWNEE, OK 74804-9329
(405) 432-0637
Mailing address
2505 MASON DR, SHAWNEE, OK 74804-9329
(405) 432-0637
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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