Individual
LOGAN TAYLOR MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4726 AIRPORT HWY, LOUISVILLE, TN 37777-5402
(865) 970-7747
Mailing address
4100 VALLEY VIEW DR, KNOXVILLE, TN 37917-1209
(501) 993-7822
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW0000012102
TN
Other
Enumeration date
09/04/2012
Last updated
03/27/2020
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